29D2263875 CLIA NUMBER - ALEXANDER DENTAL GROUP AND ORTHODONTICS

Laboratory Demographics

  • CLIA Code: 29D2263875
  • Facility Name: ALEXANDER DENTAL GROUP AND ORTHODONTICS
  • Facility Address: 3896 N MARTIN LUTHER KING BLVD
    N LAS VEGAS, NV
    ZIP 89032
  • Facility Phone: 702 614-1792
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: SHANNON K. LEE
  • NPI Number: 1952497984
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 29D2263875
LAB Type Practitioner Other
Facility Name ALEXANDER DENTAL GROUP AND ORTHODONTICS
Street 3896 N MARTIN LUTHER KING BLVD
City N LAS VEGAS
State NV
ZIP 89032
Phone 702 614-1792
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2024
Certificate Expiration Date 7/5/2026
Facility Type Practitioner Other
Lab Director SHANNON K. LEE

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