28D0453581 CLIA NUMBER - PENDER MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 28D0453581

Facility Name: PENDER MEDICAL CLINIC

Facility Address:
958 WELLNESS WAY, SUITE 1
PENDER, NE
ZIP 68047
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Facility Phone Number: 402 385-3033

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1972931657

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	28D0453581
LAB Type	Physician Office
Facility Name	PENDER MEDICAL CLINIC
Street	958 WELLNESS WAY, SUITE 1
City	PENDER
State	NE
ZIP	68047
Phone	402 385-3033
CertificateType	2
CertificateEffectiveDate	8/2/2022
CertificateExpirationDate	8/1/2024
FacilityType	Compliance

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This page was last updated on: 4/23/2024