28D0456140 CLIA NUMBER - FCMH POOL MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 28D0456140
  • Facility Name: FCMH POOL MEDICAL CLINIC
  • Facility Address: 121 15TH AVENUE
    FRANKLIN, NE
    ZIP 68939
  • Facility Phone: 308 425-6701
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROGER V. DIETZ
  • NPI Number: 1164465829
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 28D0456140
LAB Type Physician Office
Facility Name FCMH POOL MEDICAL CLINIC
Street 121 15TH AVENUE
City FRANKLIN
State NE
ZIP 68939
Phone 308 425-6701
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 Physician Office
Lab Director ROGER V. DIETZ

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