29D2160079 CLIA NUMBER - CROSSROADS OF SOUTHERN NEVADA

Laboratory Demographics

  • CLIA Code: 29D2160079
  • Facility Name: CROSSROADS OF SOUTHERN NEVADA
  • Facility Address: 2121 W CHARLESTON BLVD
    LAS VEGAS, NV
    ZIP 89102
  • Facility Phone: 702 919-5390
  • Facility Type: Other - MEDICAL DETOX
  • Facility Type: Waiver
  • Lab Director: CHARLES MCSWAIN
  • NPI Number: 1659834075
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 29D2160079
LAB Type Other - MEDICAL DETOX
Facility Name CROSSROADS OF SOUTHERN NEVADA
Street 2121 W CHARLESTON BLVD
City LAS VEGAS
State NV
ZIP 89102
Phone 702 919-5390
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2025
Certificate Expiration Date 1/2/2027
Facility Type Other - MEDICAL DETOX
Lab Director CHARLES MCSWAIN

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