29D2268726 CLIA NUMBER - CANYON RIDGE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 29D2268726
  • Facility Name: CANYON RIDGE SURGERY CENTER
  • Facility Address: 5852 S DURANGO DRIVE UNIT #100
    LAS VEGAS, NV
    ZIP 89113
  • Facility Phone: 209 401-3293
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: STEPHEN GEPHARDT
  • NPI Number: 1417653957
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 29D2268726
LAB Type Ambulatory Surgery Center
Facility Name CANYON RIDGE SURGERY CENTER
Street 5852 S DURANGO DRIVE UNIT #100
City LAS VEGAS
State NV
ZIP 89113
Phone 209 401-3293
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/15/2024
Certificate Expiration Date 9/14/2026
Facility Type Ambulatory Surgery Center
Lab Director STEPHEN GEPHARDT

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