28D0960044 CLIA NUMBER - MIDWEST ENDOSCOPY SERVICES, LLC

Laboratory Demographics

CLIA Number: 28D0960044

Facility Name: MIDWEST ENDOSCOPY SERVICES, LLC

Facility Address:
8901 INDIAN HILLS DRIVE, SUITE 100
OMAHA, NE
ZIP 68114
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Facility Phone Number: 402 933-1500

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1053385328

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	28D0960044
LAB Type	Ambulatory Surgery Center
Facility Name	MIDWEST ENDOSCOPY SERVICES, LLC
Street	8901 INDIAN HILLS DRIVE, SUITE 100
City	OMAHA
State	NE
ZIP	68114
Phone	402 933-1500
CertificateType	4
CertificateEffectiveDate	4/27/2023
CertificateExpirationDate	4/26/2025
FacilityType	Waiver

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