MAVIS N MATSUMOTO, MD, LLC
NPI 1902174741
Non-Pharmacy Dispensing Site in Henderson, NV
- Organization
- Non-Pharmacy Dispensing Site
- CLIA Number: 29D1010709
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 03-20-2027
About MAVIS N MATSUMOTO, MD, LLC
This page provides the complete NPI Profile along with additional information for Mavis N Matsumoto, Md, Llc, a provider established in Henderson, Nevada operating as a Non-pharmacy Dispensing Site. The healthcare provider is registered in the NPI registry with number 1902174741 assigned on December 2011. The practitioner's primary taxonomy code is 332900000X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Dr. Mavis Matsumoto M.d. (Owner)
- NPI
- 1902174741 Verify this NPI
- Provider Name
- MAVIS N MATSUMOTO, MD, LLC
- Entity Type
- Organization
- Location Address
- 2780 W HORIZON RIDGE PKWY SUITE 30 HENDERSON, NV 89052
- Location Phone
- (702) 992-4050
- Mailing Address
- 2980 N BEVERLY GLEN CIR SUITE 301 LOS ANGELES, CA 90077
- Mailing Phone
- (310) 474-9809
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 12-08-2011
- Last Update Date
- 04-15-2013
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Non-Pharmacy Dispensing Site
- Taxonomy Code
- 332900000X
- Type
- Suppliers
- Taxonomy Description
- A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
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 this NPI number is:
- CLIA Number
- 29D1010709
- Facility Type
- Physician Office
- Certificate Effective Date
- March 21, 2025
- Certificate Expiration Date
- March 20, 2027
- Laboratory Director
- MAVIS N. MATSUMOTO MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Mavis N Matsumoto, Md, Llc 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.
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Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
HENDERSON, NV 89052
HENDERSON, NV 89052
HENDERSON, NV 89052
HENDERSON, NV 89052
HENDERSON, NV 89052
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1902174741, enumerated as an "organization" on December 08, 2011.
The provider is located at 2780 W HORIZON RIDGE PKWY SUITE 30 HENDERSON, NV 89052 and the phone number is (702) 992-4050.
Non-Pharmacy Dispensing Site with taxonomy code 332900000X.
