29D2151921 CLIA NUMBER - ACTIVATE HEALTHCARE-CCFF LOCAL 1908 CLINIC

Laboratory Demographics

  • CLIA Code: 29D2151921
  • Facility Name: ACTIVATE HEALTHCARE-CCFF LOCAL 1908 CLINIC
  • Facility Address: 2004 S JONES BLVD
    LAS VEGAS, NV
    ZIP 89146
  • Facility Phone: 702 463-3631
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACQUELINE SARAGOSA
  • NPI Number: 1467948950
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 29D2151921
LAB Type Physician Office
Facility Name ACTIVATE HEALTHCARE-CCFF LOCAL 1908 CLINIC
Street 2004 S JONES BLVD
City LAS VEGAS
State NV
ZIP 89146
Phone 702 463-3631
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2024
Certificate Expiration Date 7/30/2026
Facility Type Physician Office
Lab Director JACQUELINE SARAGOSA

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This page was last updated on: 9/29/2025