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FUNCTIONAL MEDICINE OF NEVADA PLLC
NPI 1003409319
Family Medicine in Reno, NV

Active since February 17, 2021CLIA Certified · 4 labs
6490 S MCCARRAN BLVD STE 16, RENO, NV 89509(208) 385-7711 Get Directions Write a Review

NPPES record last updated: February 17, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Functional Medicine Of Nevada Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FUNCTIONAL MEDICINE OF NEVADA PLLC (NPI 1003409319) is a healthcare organization registered as a family medicine in Reno, Nevada and active in the NPI registry since February 2021. The organization holds 4 active CLIA laboratory certificates and lists Sam Warren, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003409319
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFUNCTIONAL MEDICINE OF NEVADA PLLC
Location Address6490 S MCCARRAN BLVD STE 16Reno, NV 89509-6165
Mailing Address3858 N Garden Center Way Ste 100Boise, ID 83703-5008 · (208) 385-7711
Phone(208) 385-7711
Organization SubpartYesParent: Functional Medicine Of Idaho Pc
Authorized OfficialSam WarrenCeo · (208) 385-7711
Enumeration DateFebruary 17, 2021
NPPES CertifiedFebruary 17, 2021
✔ NPI 1003409319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
6490 S MCCARRAN BLVD STE 16, Reno, NV 89509
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 13D0898350

Functional Medicine Of Idaho · Boise, ID
Active · expires Mar 11, 2028
CLIA Number13D0898350
Laboratory TypePhysician Office
Certificate Effective DateMarch 12, 2026
Certificate Expiration DateMarch 11, 2028
Laboratory DirectorNicholas E. Garver
Laboratory Phone(208) 385-7711
Laboratory LocationFunctional Medicine Of Idaho3858 N Garden Center Way #100, Boise, ID 83703
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 13D2166598

Functional Medicine Of Idaho · Meridian, ID
Active · expires Mar 11, 2028
CLIA Number13D2166598
Laboratory TypePhysician Office
Certificate Effective DateMarch 12, 2026
Certificate Expiration DateMarch 11, 2028
Laboratory DirectorNicholas E. Garver
Laboratory Phone(208) 385-7711
Laboratory LocationFunctional Medicine Of Idaho2939 W Excursion Ln, Meridian, ID 83642
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 13D2340106

Functional Medicine Of Idaho · Eagle, ID
Active · expires Mar 11, 2028
CLIA Number13D2340106
Laboratory TypePhysician Office
Certificate Effective DateMarch 12, 2026
Certificate Expiration DateMarch 11, 2028
Laboratory DirectorMark E. Holthouse
Laboratory Phone(208) 385-7711
Laboratory LocationFunctional Medicine Of Idaho435 S Eagle Rd, Suite 100, Eagle, ID 83616
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 13D2340154

Functional Medicine Of Idaho · Boise, ID
Active · expires Mar 11, 2028
CLIA Number13D2340154
Laboratory TypePhysician Office
Certificate Effective DateMarch 12, 2026
Certificate Expiration DateMarch 11, 2028
Laboratory DirectorNicholas E. Garver
Laboratory Phone(208) 385-7711
Laboratory LocationFunctional Medicine Of Idaho3858 N Garden Center Way, Ste 120, Boise, ID 83703
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Functional Medicine Of Nevada PLLC's NPI number?

The NPI number for Functional Medicine Of Nevada PLLC is 1003409319. It was assigned to this organization in the NPPES registry on February 17, 2021.

Where is Functional Medicine Of Nevada PLLC located?

Functional Medicine Of Nevada PLLC is located at 6490 S Mccarran Blvd Ste 16, Reno, NV 89509. The listed phone number is (208) 385-7711.

What is Functional Medicine Of Nevada PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Functional Medicine Of Nevada PLLC hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Functional Medicine Of Nevada PLLC was last updated on February 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.