SURGEON'S SURGERY CENTER SORELLE PLLC NPI 1457813107

Clinic/Center (Ambulatory Surgical) in Las Vegas, NV

Organization Clinic/Center Ambulatory Surgical CLIA Number 29D2173788 CLIA Certificate of Waiver

About SURGEON'S SURGERY CENTER SORELLE PLLC

Surgeon's Surgery Center Sorelle Pllc is a provider established in Las Vegas, Nevada specializing in clinic/center. The NPI number of Surgeon's Surgery Center Sorelle Pllc is 1457813107 and was assigned on April 2019. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Jonathan R Sorelle Md (President)

The CLIA number of Surgeon's Surgery Center Sorelle Pllc is 29D2173788 registered as a "ambulatory surgery center" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Surgeon's Surgery Center Sorelle Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1457813107

Provider NameSURGEON'S SURGERY CENTER SORELLE PLLC
Provider Location Address6940 S CIMARRON RD STE 100 LAS VEGAS, NV 89113
Provider Mailing AddressPO BOX 400310 LAS VEGAS, NV 89140
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date04-02-2019
Last Update Date10-01-2019

Primary Taxonomy

Taxonomy Code261QA1903X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationAmbulatory Surgical

Business Address

SURGEON'S SURGERY CENTER SORELLE PLLC
6940 S CIMARRON RD STE 100
LAS VEGAS, NV
ZIP 89113
Phone: (702) 739-4263
Fax: (833) 787-4371

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Mailing Address

SURGEON'S SURGERY CENTER SORELLE PLLC
PO BOX 400310
LAS VEGAS, NV
ZIP 89140
Phone: (702) 739-4263
Fax: (833) 787-4371

Authorized Official

Authorized Official Name JONATHAN R SORELLE MD
Authorized Official TitlePRESIDENT
Authorized Official Phone(702) 739-4263

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 1457813107 is:

CLIA Number29D2173788
Facility TypeAMBULATORY SURGERY CENTER
Certificate TypeCertificate of Waiver

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.