28D0455773 CLIA NUMBER - RIVERSIDE LODGE

Laboratory Demographics

  • CLIA Code: 28D0455773
  • Facility Name: RIVERSIDE LODGE
  • Facility Address: 404 WOODLAND DR
    GRAND ISLAND, NE
    ZIP 68801
  • Facility Phone: 308 382-1657
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: CHRISTI TUXHORN-OLSON
  • NPI Number: 1962784819
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 28D0455773
LAB Type Other
Facility Name RIVERSIDE LODGE
Street 404 WOODLAND DR
City GRAND ISLAND
State NE
ZIP 68801
Phone 308 382-1657
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 Other
Lab Director CHRISTI TUXHORN-OLSON

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