28D0454044 CLIA NUMBER - PACIFIC SURGERY CENTER EAST

Laboratory Demographics

  • CLIA Code: 28D0454044
  • Facility Name: PACIFIC SURGERY CENTER EAST
  • Facility Address: 111 1/2 S 90TH STREET
    OMAHA, NE
    ZIP 68114
  • Facility Phone: 402 397-7178
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JON J. MORTON
  • NPI Number: 1912909144
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 28D0454044
LAB Type Ambulatory Surgery Center
Facility Name PACIFIC SURGERY CENTER EAST
Street 111 1/2 S 90TH STREET
City OMAHA
State NE
ZIP 68114
Phone 402 397-7178
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Ambulatory Surgery Center
Lab Director JON J. MORTON

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This page was last updated on: 9/29/2025