Organization
LABORATORY SERVICES OF NEVADA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAKESH KUTHURU (MANAGING PARTNER)
(315) 857-3648
Entity
Organization
Contact information
Practice address
3376 S EASTERN AVE STE 170, LAS VEGAS, NV 89169-3397
(702) 684-6000
(702) 684-6002
Mailing address
3376 S EASTERN AVE STE 170, LAS VEGAS, NV 89169-3397
(702) 684-6000
(702) 684-6002
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
5562LIC
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29D1094377
CLIA NUMBER
—
01
—
5562LIC
DIVISION OF HEALTH LICENSE
NV
Enumeration date
10/30/2010
Last updated
10/30/2010
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