28D0982557 CLIA NUMBER - PONCA HILLS VOLUNTEER FIRE DEPT

Laboratory Demographics

  • CLIA Code: 28D0982557
  • Facility Name: PONCA HILLS VOLUNTEER FIRE DEPT
  • Facility Address: 12919 PONCA ROAD
    OMAHA, NE
    ZIP 68112
  • Facility Phone: 402 453-6656
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: LESLIE HOGBERG
  • NPI Number: 1942676648
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 28D0982557
LAB Type Ambulance
Facility Name PONCA HILLS VOLUNTEER FIRE DEPT
Street 12919 PONCA ROAD
City OMAHA
State NE
ZIP 68112
Phone 402 453-6656
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2025
Certificate Expiration Date 1/29/2027
Facility Type Ambulance
Lab Director LESLIE HOGBERG

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