29D2165660 CLIA NUMBER - SUNRISE PEDIATRICS-GREEN VALLEY

Laboratory Demographics

  • CLIA Code: 29D2165660
  • Facility Name: SUNRISE PEDIATRICS-GREEN VALLEY
  • Facility Address: 1701 N GREEN VALLEY PKWY STE 10A
    HENDERSON, NV
    ZIP 89074
  • Facility Phone: 702 254-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SANJAY W. KANDOTH
  • NPI Number: 1487824223
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 29D2165660
LAB Type Physician Office
Facility Name SUNRISE PEDIATRICS-GREEN VALLEY
Street 1701 N GREEN VALLEY PKWY STE 10A
City HENDERSON
State NV
ZIP 89074
Phone 702 254-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/2/2025
Certificate Expiration Date 5/1/2027
Facility Type Physician Office
Lab Director SANJAY W. KANDOTH

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