29D2247859 CLIA NUMBER - CENTERWELL SENIOR PRIMARY CARE-BOULDER HWY

Laboratory Demographics

  • CLIA Code: 29D2247859
  • Facility Name: CENTERWELL SENIOR PRIMARY CARE-BOULDER HWY
  • Facility Address: 6360 BOULDER HWY
    LAS VEGAS, NV
    ZIP 89122
  • Facility Phone: 725 228-4520
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TRACY WAKEFIELD
  • NPI Number: 1831765692
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 29D2247859
LAB Type Physician Office
Facility Name CENTERWELL SENIOR PRIMARY CARE-BOULDER HWY
Street 6360 BOULDER HWY
City LAS VEGAS
State NV
ZIP 89122
Phone 725 228-4520
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2024
Certificate Expiration Date 1/9/2026
Facility Type Physician Office
Lab Director TRACY WAKEFIELD

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