LAKES DERMATOLOGY SKIN CANCER & LASER CENTER INC NPI 1134288178

Dermatology in Las Vegas, NV

NPI 1134288178 Organization Dermatology CLIA Number 29D0983069 CLIA Certificate of Compliance

About LAKES DERMATOLOGY SKIN CANCER & LASER CENTER INC

Lakes Dermatology Skin Cancer & Laser Center Inc is a provider established in Las Vegas, Nevada specializing in dermatology. The NPI number of Lakes Dermatology Skin Cancer & Laser Center Inc is 1134288178 and was assigned on December 2006. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. Lakes Dermatology Skin Cancer & Laser Center Inc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Ms. Allison Rose Rueckl (Billing Manager)

A dermatologist like Lakes Dermatology Skin Cancer & Laser Center Inc is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.

The CLIA number of Lakes Dermatology Skin Cancer & Laser Center Inc is 29D0983069 registered as a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued to Lakes Dermatology Skin Cancer & Laser Center Inc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

NPI

1134288178

Provider NameLAKES DERMATOLOGY SKIN CANCER & LASER CENTER INC
Provider Location Address8937 W SAHARA AVE STE B LAS VEGAS, NV 89117
Provider Mailing Address8937 W SAHARA AVE STE B LAS VEGAS, NV 89117
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date12-06-2006
Last Update Date11-06-2007


Primary Taxonomy

Taxonomy Code207N00000X
ClassificationDermatology
TypeAllopathic & Osteopathic Physicians
Taxonomy DescriptionA dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Business Address

LAKES DERMATOLOGY SKIN CANCER & LASER CENTER INC
8937 W SAHARA AVE
STE B
LAS VEGAS, NV
ZIP 89117
Phone: (702) 869-6667
Fax: (702) 869-2627

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Mailing Address

LAKES DERMATOLOGY SKIN CANCER & LASER CENTER INC
8937 W SAHARA AVE
STE B
LAS VEGAS, NV
ZIP 89117
Phone: (702) 869-6667
Fax: (702) 869-2627



Authorized Official

Authorized Official NameMS. ALLISON ROSE RUECKL
Authorized Official TitleBILLING MANAGER
Authorized Official Phone(702) 869-6667

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1134288178 is:

CLIA Number29D0983069
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Compliance

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
V33652MEDICARE PIN (08)NV
C96528MEDICARE UPIN (02)NV

Other Providers at the same location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1336259332DR. JAMES ANIELLO BECKWITH O.D.
Individual
Optometrist8937 W SAHARA AVE SUITE A
LAS VEGAS, NV 89117
(702) 254-3558
1023292810MRS. ALISSA DANAE NAGEL-ESPOSITO O.D.
Individual
Optometrist8937 W SAHARA AVE STE. A
LAS VEGAS, NV 89117
(702) 254-3558
1124265046OPTOMETRIC PARTNERSHIP LLC
Organization
Optometrist8937 W SAHARA AVE SUITE A
LAS VEGAS, NV 89117
(702) 254-3558
1669400172 MARK ROBERT LEE O.D.
Individual
Optometrist8937 W SAHARA AVE SUITE A
LAS VEGAS, NV 89117
(702) 254-3558
1760605018JAMES A. BECKWITH, O.D., INC.
Organization
Optometrist8937 W SAHARA AVE SUITE A
LAS VEGAS, NV 89117
(702) 254-3558

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.