28D0455599 CLIA NUMBER - AVERA MEDICAL GROUP - HARTINGTON

Laboratory Demographics

CLIA Number: 28D0455599

Facility Name: AVERA MEDICAL GROUP - HARTINGTON

Facility Address:
405 WEST DARLENE
HARTINGTON, NE
ZIP 68739
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Facility Phone Number: 402 254-3935

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1518226190

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	28D0455599
LAB Type	Physician Office
Facility Name	AVERA MEDICAL GROUP - HARTINGTON
Street	405 WEST DARLENE
City	HARTINGTON
State	NE
ZIP	68739
Phone	402 254-3935
CertificateType	2
CertificateEffectiveDate	7/9/2023
CertificateExpirationDate	7/8/2025
FacilityType	Compliance

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