29D2197195 CLIA NUMBER - CENTERWELL SENIOR PRIMARY CARE - SOUTH NELLIS

Laboratory Demographics

  • CLIA Code: 29D2197195
  • Facility Name: CENTERWELL SENIOR PRIMARY CARE - SOUTH NELLIS
  • Facility Address: 2875 S NELLIS BLVD STE 3
    LAS VEGAS, NV
    ZIP 89121
  • Facility Phone: 702 843-2420
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TRACY WAKEFIELD
  • NPI Number: 1306469788
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 29D2197195
LAB Type Physician Office
Facility Name CENTERWELL SENIOR PRIMARY CARE - SOUTH NELLIS
Street 2875 S NELLIS BLVD STE 3
City LAS VEGAS
State NV
ZIP 89121
Phone 702 843-2420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2024
Certificate Expiration Date 10/21/2026
Facility Type Physician Office
Lab Director TRACY WAKEFIELD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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