29D2264470 CLIA NUMBER - HORIZON RIDGE MODERN DENTISTRY

Laboratory Demographics

  • CLIA Code: 29D2264470
  • Facility Name: HORIZON RIDGE MODERN DENTISTRY
  • Facility Address: 10525 S EASTERN AVENUE, SUITE 100
    HENDERSON, NV
    ZIP 89052
  • Facility Phone: 702 508-0906
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MANDY M. YIP
  • NPI Number: 1346374238
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 29D2264470
LAB Type Practitioner Other
Facility Name HORIZON RIDGE MODERN DENTISTRY
Street 10525 S EASTERN AVENUE, SUITE 100
City HENDERSON
State NV
ZIP 89052
Phone 702 508-0906
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2024
Certificate Expiration Date 7/13/2026
Facility Type Practitioner Other
Lab Director MANDY M. YIP

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This page was last updated on: 3/20/2025