28D0900738 CLIA NUMBER - SOUTH OMAHA MEDICAL ASSOCIATES

Laboratory Demographics

CLIA Number: 28D0900738

Facility Name: SOUTH OMAHA MEDICAL ASSOCIATES

Facility Address:
4828 SOUTH 24TH STREET
OMAHA, NE
ZIP 68107
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Facility Phone Number: 402 731-9100

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1649471913

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	28D0900738
LAB Type	Physician Office
Facility Name	SOUTH OMAHA MEDICAL ASSOCIATES
Street	4828 SOUTH 24TH STREET
City	OMAHA
State	NE
ZIP	68107
Phone	402 731-9100
CertificateType	4
CertificateEffectiveDate	6/19/2022
CertificateExpirationDate	6/18/2024
FacilityType	Waiver

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