29D2297807 CLIA NUMBER - GENOA HEALTHCARE LLC - 20390

Laboratory Demographics

  • CLIA Code: 29D2297807
  • Facility Name: GENOA HEALTHCARE LLC - 20390
  • Facility Address: 701 SHADOW LANE, SUITE 110
    LAS VEGAS, NV
    ZIP 89106
  • Facility Phone: 877 480-1755
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN HUYNH
  • NPI Number: 1669040283
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 29D2297807
LAB Type Pharmacy
Facility Name GENOA HEALTHCARE LLC - 20390
Street 701 SHADOW LANE, SUITE 110
City LAS VEGAS
State NV
ZIP 89106
Phone 877 480-1755
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/23/2024
Certificate Expiration Date 1/22/2026
Facility Type Pharmacy
Lab Director SUSAN HUYNH

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