28D0455707 CLIA NUMBER - PROVIDENCE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 28D0455707
  • Facility Name: PROVIDENCE MEDICAL CENTER
  • Facility Address: 1200 PROVIDENCE ROAD
    WAYNE, NE
    ZIP 68787
  • Facility Phone: 402 375-7986
  • Facility Type: Hospital
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. JULIE BREINER
  • NPI Number: 1801867494
  • Taxonomy: 282NC0060X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 28D0455707
LAB Type Hospital
Facility Name PROVIDENCE MEDICAL CENTER
Street 1200 PROVIDENCE ROAD
City WAYNE
State NE
ZIP 68787
Phone 402 375-7986
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 1/4/2024
Certificate Expiration Date 1/3/2026
Facility Type Hospital
Lab Director DR. JULIE BREINER

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