28D0964201 CLIA NUMBER - BAKERS PHARMACY #320

Laboratory Demographics

  • CLIA Code: 28D0964201
  • Facility Name: BAKERS PHARMACY #320
  • Facility Address: 17370 LAKESIDE HILLS PLAZA
    OMAHA, NE
    ZIP 68130
  • Facility Phone: 402 333-5351
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICKE ROBERTS
  • NPI Number: 1285674077
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 28D0964201
LAB Type Pharmacy
Facility Name BAKERS PHARMACY #320
Street 17370 LAKESIDE HILLS PLAZA
City OMAHA
State NE
ZIP 68130
Phone 402 333-5351
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2025
Certificate Expiration Date 4/14/2027
Facility Type Pharmacy
Lab Director MICKE ROBERTS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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