29D2195317 CLIA NUMBER - WEST SIDE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 29D2195317
  • Facility Name: WEST SIDE PEDIATRICS
  • Facility Address: 8440 W LAKE MEAD BLVD STE 104
    LAS VEGAS, NV
    ZIP 89128
  • Facility Phone: 702 682-9033
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LESA V. BROOKES
  • NPI Number: 1255529590
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 29D2195317
LAB Type Physician Office
Facility Name WEST SIDE PEDIATRICS
Street 8440 W LAKE MEAD BLVD STE 104
City LAS VEGAS
State NV
ZIP 89128
Phone 702 682-9033
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2024
Certificate Expiration Date 10/6/2026
Facility Type Physician Office
Lab Director LESA V. BROOKES

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