28D0455581 CLIA NUMBER - AVERA MEDICAL GROUP BUTTE

Laboratory Demographics

  • CLIA Code: 28D0455581
  • Facility Name: AVERA MEDICAL GROUP BUTTE
  • Facility Address: 730 WILSON ST PO BOX 319
    BUTTE, NE
    ZIP 68722
  • Facility Phone: 402 775-2508
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LISA A. EVEN, MD
  • NPI Number: 1568492551
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 28D0455581
LAB Type Physician Office
Facility Name AVERA MEDICAL GROUP BUTTE
Street 730 WILSON ST PO BOX 319
City BUTTE
State NE
ZIP 68722
Phone 402 775-2508
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director LISA A. EVEN, MD

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