Organization
EXELLABS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QIYUAN PENG PH.D. (LAB DIRECTOR)
(702) 527-5501
Entity
Organization
Contact information
Practice address
5130 S PECOS RD STE 2B, LAS VEGAS, NV 89120-1248
(702) 527-5501
Mailing address
3365 E FLAMINGO RD, #3, LAS VEGAS, NV 89121-6800
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
8371LIC
NV
Other
Enumeration date
08/16/2015
Last updated
01/04/2019
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