28D0652699 CLIA NUMBER - GORDON COUNTRYSIDE CARE

Laboratory Demographics

  • CLIA Code: 28D0652699
  • Facility Name: GORDON COUNTRYSIDE CARE
  • Facility Address: 500 E 10TH ST
    GORDON, NE
    ZIP 69343
  • Facility Phone: 308 282-0806
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. ANPO W. CHARGING THUNDER
  • NPI Number: 1083602692
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 28D0652699
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GORDON COUNTRYSIDE CARE
Street 500 E 10TH ST
City GORDON
State NE
ZIP 69343
Phone 308 282-0806
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 Skilled Nursing Facility/Nursing Facility
Lab Director DR. ANPO W. CHARGING THUNDER

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