28D0958691 CLIA NUMBER - DAVENPORT MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 28D0958691
  • Facility Name: DAVENPORT MEDICAL CLINIC
  • Facility Address: 105 LINDEN AVE
    DAVENPORT, NE
    ZIP 68335
  • Facility Phone: 402 768-7203
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DR. BRYAN HUBL
  • NPI Number: 1972589349
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 28D0958691
LAB Type Rural Health Clinic
Facility Name DAVENPORT MEDICAL CLINIC
Street 105 LINDEN AVE
City DAVENPORT
State NE
ZIP 68335
Phone 402 768-7203
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Rural Health Clinic
Lab Director DR. BRYAN HUBL

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