29D2264172 CLIA NUMBER - CHARLESTON SMILES DENTISTRY

Laboratory Demographics

  • CLIA Code: 29D2264172
  • Facility Name: CHARLESTON SMILES DENTISTRY
  • Facility Address: 1150 S NELLIS BLVD, SUITE 200
    LAS VEGAS, NV
    ZIP 89104
  • Facility Phone: 702 505-9159
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DAVID HERNANDEZ
  • NPI Number: 1871788554
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 29D2264172
LAB Type Practitioner Other
Facility Name CHARLESTON SMILES DENTISTRY
Street 1150 S NELLIS BLVD, SUITE 200
City LAS VEGAS
State NV
ZIP 89104
Phone 702 505-9159
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2024
Certificate Expiration Date 7/10/2026
Facility Type Practitioner Other
Lab Director DAVID HERNANDEZ

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