28D0720111 CLIA NUMBER - WESTGATE ASSISTED LIVING

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Laboratory Demographics

CLIA Number: 28D0720111

Facility Name: WESTGATE ASSISTED LIVING

Facility Address:
3030 S 80TH ST
OMAHA, NE
ZIP 68124
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Facility Phone Number: 402 391-8566

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1013963412

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	28D0720111
LAB Type	Other
Facility Name	WESTGATE ASSISTED LIVING
Street	3030 S 80TH ST
City	OMAHA
State	NE
ZIP	68124
Phone	402 391-8566
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024