29D2264169 CLIA NUMBER - SILVERADO RANCH DENTISTRY

Laboratory Demographics

CLIA Number: 29D2264169

Facility Name: SILVERADO RANCH DENTISTRY

Facility Address:
45 E SILVERADO RANCH BLVD, SUITE 100
LAS VEGAS, NV
ZIP 89183
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Facility Phone Number: 702 425-6810

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1235145996

Taxonomy: 261QD0000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	29D2264169
LAB Type	Practitioner Other
Facility Name	SILVERADO RANCH DENTISTRY
Street	45 E SILVERADO RANCH BLVD, SUITE 100
City	LAS VEGAS
State	NV
ZIP	89183
Phone	702 425-6810
CertificateType	4
CertificateEffectiveDate	7/11/2022
CertificateExpirationDate	7/10/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024