Stack of documents with a paperweight on a leather desk pad, How to Open a Med Spa in Nevada: Ownership and Licensing

How to Start a Med Spa Business in Nevada

Last verified: November 5, 2026

We searched NRS chapters 449, 630, 644A and 89 and none uses the term medical spa for a license, so confirm with the Board of Medical Examiners before you plan around one. What the statutes regulate is who performs each treatment and who may own the practice that delivers it, so the order of your decisions matters: settle the treatment menu and the clinician who will stand behind it first, form the entity second, license the space last.

This guide is for someone opening a med spa who has not yet decided whether to hold the clinical license personally or to bring one in. If you cannot name a licensed physician, physician assistant or advanced practice registered nurse who will accept responsibility for the clinical side, do not sign a lease yet.

Step 1: Sort Your Treatment Menu by Who May Perform It

Nevada sorts med spa services into three buckets, and each has a different regulator. Medicine is licensed by the Board of Medical Examiners (NRS 630.010). Esthetic work is licensed by the Nevada State Board of Cosmetology. A building can need a health facility license from the Division of Public and Behavioral Health only if it is one of the facility types listed in NRS 449.0151, such as a surgical center for ambulatory patients. A med spa is not on that list.

The practice of medicine includes any effort to diagnose, treat, correct, prevent or prescribe for a disease, injury, deformity or other condition "by any means or instrumentality" (NRS 630.020). Doing that without a license is a felony, a category D felony when no substantial bodily harm results (NRS 630.400). So the menu decides your staffing:

ServiceWho may perform itSource
Nonablative device procedures (permanent hair reduction, skin tightening, noninvasive body contouring)An advanced esthetician, but only while a physician, physician assistant or advanced practice registered nurse is reachable in real time and within 60 miles or 60 minutesNRS 644A.063, NRS 644A.545(1)
Ablative procedures (anything expected to excise, vaporize, disintegrate or remove living tissue)Not an advanced esthetician. The clinician's own licensing board decides who else may do it.NRS 644A.011, NRS 644A.545(2)
Microneedling and medium-depth chemical peels for esthetic purposesAdvanced esthetician license. The statute lists these as advanced esthetic procedures separately from device procedures, so ask the Board of Cosmetology whether the supervision rule above reaches your specific device.NRS 644A.012
Injectables, prescription products, treating a medical conditionA licensed clinician acting within the scope of their own license. We found no cosmetology-law route for these.NRS 630.020, NRS 630.400

One more rule shapes the menu: a physician, physician assistant or advanced practice registered nurse counts as a "health care professional" under NRS 453C.030, and that is the list the esthetician supervision rule uses. A nurse practitioner can therefore supervise an advanced esthetician under the cosmetology statute. Whether a nurse practitioner may direct injectable services on their own is a question for the Nevada State Board of Nursing, which we did not confirm.

Step 2: Decide Who Owns the Clinical Practice

This is where most Nevada med spa plans go wrong, and it comes before the LLC filing. A Nevada professional entity (a professional corporation or professional LLC) for medicine may issue ownership only to a natural person licensed to render the same professional service (NRS 89.070(1)(a)). It may do nothing except that service and services reasonably related to it (NRS 89.050(1)), and it may render the service only through licensed officers, managers and employees (NRS 89.050(3)).

The same chapter bars the owners of a medical professional entity from overriding a licensed clinician's judgment, including on patient care, hiring and firing, and billing codes, and from setting patient or hours quotas (NRS 89.055(1)). The only carve-out for shared ownership that we found in the medical practice act is for nonprofit medical schools and research institutions (NRS 630.365).

What this means in practice, labelled as our reading and not legal advice:

  • If you are a Nevada-licensed physician: the clinical side can be a professional LLC that you own, and your own license carries the supervision.
  • If you are not licensed: you cannot hold ownership in the clinical professional entity. Many owners therefore keep the clinical practice and the spa or retail company as separate entities with a written services agreement. How that agreement is drafted is a healthcare attorney's job, and the Board of Medical Examiners (medboard.nv.gov) is the place to test it before you commit.
  • If you are an esthetician owner: a spa limited to esthetic services is a cosmetology business, not a medical one. It crosses into medicine when it adds anything from the last row of the table above.

Step 3: Form the Entity and Pay the State Fees

Search the name on the Nevada Secretary of State entity search, and if you need time, reserve it for 90 days for $25 (Secretary of State name reservation). File through the SilverFlume portal.

A professional LLC must say in its articles which profession it practices and must attach a certificate from the regulating board showing each member is licensed (NRS 89.040(1)). Chapters 78 and 86 apply to professional entities unless chapter 89 conflicts (NRS 89.030), so the fees below should apply, but we could not read the Secretary of State's current fee schedule, so confirm the professional entity fee before you pay. If you form a general LLC for the spa side, the numbers are:

  • Articles of organization: $75 (NRS 86.561).
  • Initial list of managers or members: $150, filed with the articles (NRS 86.263(1)).
  • State business license: $200 for an LLC, $500 for a corporation (NRS 76.100), paid when you file the initial list and renewed each year with the annual list (NRS 76.100(1)). Operating without it adds a $100 penalty (NRS 76.110).
  • Annual list after year one: $150 for an LLC, due by the end of the anniversary month (NRS 86.263(2)).

That is $425 in the first year and $350 each year after for an LLC. A corporation pays $75 or more to file (the fee rises with authorized shares, NRS 78.760), the same $150 initial list and a $500 license, so $725 at the lowest tier. Expedited filing has statutory ceilings of $125 (24 hours), $500 (2 hours) and $1,000 (1 hour) under NRS 225.140; the amount actually charged is on the Secretary of State's schedule, which we could not read. The Nevada LLC guide covers the filing in more detail, and you can compare LLC formation services in Nevada if you would rather not file yourself.

You need a registered agent with a physical Nevada address who signs a certificate of acceptance (NRS 77.300, NRS 77.310). You can serve as your own agent. Prices for hired agents are set by the providers, not the state; see our registered agent guide.

Step 4: Register for Federal and State Taxes

Get your EIN free from the IRS (see our Nevada EIN guide). Nevada charges no state income tax (Nevada Department of Taxation), but a med spa with staff still has two business taxes to know:

If you sell skincare or other products, you need a seller's permit, $15 per location (Department of Taxation: start a business). The Department states a 6.85% base state rate, and the total at your address depends on the county, so check its sales and use tax publications. Its sales tax FAQ says services not tied to tangible property are not taxable, so product sales are taxed and the treatment itself generally is not. Ask the Department how it treats a package that bundles the two.

Step 5: License the Space and the People

The Board of Cosmetology licenses a "cosmetological establishment," meaning any premises where cosmetology is practiced (NRS 644A.025), and its rules list estheticians and advanced estheticians among the people who work in one (NRS 644A.620). If estheticians will work in your space, plan for this license:

  • Application: a detailed floor plan, an opening inspection before the license issues, and a 2-year fee of $200 or 4-year fee of $400 plus a $15 initial inspection fee (NRS 644A.600). The Board's fee table shows new salon licenses at $215 for 2 years and $415 for 4 years.
  • Changes: the Board must be told of any change of ownership, name, services offered or location, and a new license is required before you operate after the change (NRS 644A.605). Adding a service line later can therefore mean a new license.
  • Individual licenses: esthetician licenses are $70 for 2 years or $140 for 4 years on the Board's fee table. The advanced esthetician fee is not on that table, so confirm it with the Board. Check every hire with the Board's licensee lookup.

Physicians, nurses and other licensed medical practitioners are exempt from the cosmetology chapter except for its advanced esthetician provisions, and a health care professional is exempt from those too (NRS 644A.150). Our reading is that a physician's own treatment room does not need the establishment license, while the esthetician room does. The statute also lets an establishment lease space to a health care provider, and lets the supervising clinician work in that space while an advanced esthetician is treating (NRS 644A.615), which is a workable layout for a physician who wants to rent into an esthetic spa. Confirm any hybrid layout with the Board before you sign a lease.

Check clinicians through their own boards, the Board of Medical Examiners for physicians and physician assistants and the State Board of Nursing for nurses and advanced practice registered nurses. If your plans include anything resembling surgery or sedation, ask the Division of Public and Behavioral Health whether the space falls under NRS 449.0151 before you build out.

Step 6: Get the City or County License

Local licensing is separate from every state step. In Clark County, six jurisdictions license businesses: Clark County for unincorporated areas, Henderson, Las Vegas, North Las Vegas, Boulder City and Mesquite (Clark County: business license guide). Reno licenses its own businesses (City of Reno: business license guide). Our Clark County business license page and Washoe County page cover the county side. We did not verify local fee amounts or zoning rules for medical offices, so get the fee schedule and permitted-use answer from the issuing office before you sign a lease.

Step 7: Insurance, Records and Advertising

We found no Nevada statute that sets a malpractice or general liability minimum for a med spa. Your lease, your supervising clinician's contract and your carrier set those limits, and the useful question for a carrier is whether it will cover your ownership structure from Step 2. Workers' compensation rules are in our workers compensation guide and general coverage is in the business insurance guide.

Do not advertise a treatment that no one on your payroll may legally perform. Unlicensed practice is a felony under NRS 630.400, and the Board of Cosmetology can fine a licensee up to $2,000 (NRS 644A.800).

Step 8: Put the Work in This Order

  1. Write the treatment menu and mark each service against the table in Step 1.
  2. Sign up the supervising clinician, and decide the ownership structure with a healthcare attorney.
  3. Form the entities and get the EIN and state business license.
  4. Negotiate the lease with permitted use written in, then apply for the Board of Cosmetology establishment license and the local license.
  5. Register for taxes and buy insurance.
  6. Verify every license on staff and open.

We do not publish an opening timeline because we found no official processing times for these licenses; the Board's inspection and your clinician's availability are the two things most likely to set your date.

Costs

ItemCostSource and notes
LLC articles of organization$75NRS 86.561
Initial list (filed with the articles)$150NRS 86.263
State business license (LLC)$200 a yearNRS 76.100
Annual list after year one$150 a yearNRS 86.263
Name reservation (optional)$25 for 90 daysSecretary of State
Seller's permit (if you sell products)$15 per locationDepartment of Taxation
Cosmetological establishment license$215 for 2 years, $415 for 4 years (new)Board of Cosmetology fee table
Esthetician license$70 for 2 years, $140 for 4 yearsBoard of Cosmetology fee table; advanced esthetician fee not listed
Supervising clinician, malpractice insurance, build-out, equipment, local licenseNo official figurePriced by the provider, landlord or city; get written quotes

What This Guide Could Not Confirm

  • We read NRS chapters 89, 449, 630 and 644A. We found no statute that creates a med spa license or requires a "medical director," but we did not read the administrative code or the Boards' advisory opinions, which may add duties.
  • Secretary of State fee pages are not readable from our servers, so filing fees come from statute and the professional entity fee is unconfirmed.
  • Local fees, zoning and health department requirements for medical offices were not verified.
  • Who may direct injectable services and who may prescribe are matters for the Board of Medical Examiners and the Board of Nursing.

Disclaimer

This article is general information, not legal, tax or medical advice. Ownership structure and clinical supervision for a med spa turn on facts that a Nevada healthcare attorney and the licensing boards should confirm before you file or sign.

Sources

Keep exploring: related Nevada guides