29D2260332 CLIA NUMBER - SAN JUAN MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 29D2260332
  • Facility Name: SAN JUAN MEDICAL CENTER
  • Facility Address: 4255 E CHARLESTON BLVD, STE F & G
    LAS VEGAS, NV
    ZIP 89104
  • Facility Phone: 702 381-7323
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MIJUNG KIM
  • NPI Number: 1881263309
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 29D2260332
LAB Type Physician Office
Facility Name SAN JUAN MEDICAL CENTER
Street 4255 E CHARLESTON BLVD, STE F & G
City LAS VEGAS
State NV
ZIP 89104
Phone 702 381-7323
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2024
Certificate Expiration Date 5/16/2026
Facility Type Physician Office
Lab Director MIJUNG KIM

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