29D2269108 CLIA NUMBER - PDS MEDICAL GROUP QUEENSRIDGE

Laboratory Demographics

  • CLIA Code: 29D2269108
  • Facility Name: PDS MEDICAL GROUP QUEENSRIDGE
  • Facility Address: 10040 ALTA DR, STE 100B
    LAS VEGAS, NV
    ZIP 89145
  • Facility Phone: 702 960-0689
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HARRIS KHAKWANI
  • NPI Number: 1780322750
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 29D2269108
LAB Type Physician Office
Facility Name PDS MEDICAL GROUP QUEENSRIDGE
Street 10040 ALTA DR, STE 100B
City LAS VEGAS
State NV
ZIP 89145
Phone 702 960-0689
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2024
Certificate Expiration Date 9/20/2026
Facility Type Physician Office
Lab Director HARRIS KHAKWANI

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