29D2207609 CLIA NUMBER - CENTERWELL SENIOR PRIMARY CARE-N LAS VEGAS

Laboratory Demographics

  • CLIA Code: 29D2207609
  • Facility Name: CENTERWELL SENIOR PRIMARY CARE-N LAS VEGAS
  • Facility Address: 2335 EAST LAKE MEAD BLVD
    N LAS VEGAS, NV
    ZIP 89030
  • Facility Phone: 702 577-1910
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TRACY J. WAKEFIELD
  • NPI Number: 1265196893
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 29D2207609
LAB Type Physician Office
Facility Name CENTERWELL SENIOR PRIMARY CARE-N LAS VEGAS
Street 2335 EAST LAKE MEAD BLVD
City N LAS VEGAS
State NV
ZIP 89030
Phone 702 577-1910
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2024
Certificate Expiration Date 12/28/2026
Facility Type Physician Office
Lab Director TRACY J. WAKEFIELD

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