29D2168275 CLIA NUMBER - JADE HOUSE MANAGED CARE

Laboratory Demographics

CLIA Number: 29D2168275

Facility Name: JADE HOUSE MANAGED CARE

Facility Address:
120 CORDERO RD
MCDERMITT, NV
ZIP 89421
Get Directions

Facility Phone Number: 775 532-4366

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1366005845

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	29D2168275
LAB Type	Practitioner Other
Facility Name	JADE HOUSE MANAGED CARE
Street	120 CORDERO RD
City	MCDERMITT
State	NV
ZIP	89421
Phone	775 532-4366
CertificateType	4
CertificateEffectiveDate	6/25/2023
CertificateExpirationDate	6/24/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024