29D2205402 CLIA NUMBER - HAVENBROOK

Laboratory Demographics

  • CLIA Code: 29D2205402
  • Facility Name: HAVENBROOK
  • Facility Address: 7711 FOREDAWN DR
    LAS VEGAS, NV
    ZIP 89123
  • Facility Phone: 801 644-4706
  • Facility Type: Other - RESIDENTIAL GROUP HOME
  • Facility Type: Waiver
  • Lab Director: SUZZANNE HADLEY
  • NPI Number: 1912644915
  • Taxonomy: 311ZA0620X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 29D2205402
LAB Type Other - RESIDENTIAL GROUP HOME
Facility Name HAVENBROOK
Street 7711 FOREDAWN DR
City LAS VEGAS
State NV
ZIP 89123
Phone 801 644-4706
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2024
Certificate Expiration Date 12/13/2026
Facility Type Other - RESIDENTIAL GROUP HOME
Lab Director SUZZANNE HADLEY

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