28D0662416 CLIA NUMBER - GRANT MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 28D0662416
  • Facility Name: GRANT MEDICAL CLINIC
  • Facility Address: 912 CENTRAL AVENUE
    GRANT, NE
    ZIP 69140
  • Facility Phone: 308 352-7100
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: KRISTI S. KOHL MD
  • NPI Number: 1790792729
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 28D0662416
LAB Type Rural Health Clinic
Facility Name GRANT MEDICAL CLINIC
Street 912 CENTRAL AVENUE
City GRANT
State NE
ZIP 69140
Phone 308 352-7100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/1/2024
Certificate Expiration Date 11/30/2026
Facility Type Rural Health Clinic
Lab Director KRISTI S. KOHL MD

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