28D0988021 CLIA NUMBER - CHILDREN'S PHYSICIANS-MISSION VILLAGE

Laboratory Demographics

  • CLIA Code: 28D0988021
  • Facility Name: CHILDREN'S PHYSICIANS-MISSION VILLAGE
  • Facility Address: 16909 Q STREET
    OMAHA, NE
    ZIP 68135
  • Facility Phone: 402 955-7575
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. KELLEN WALSH
  • NPI Number: 1700165743
  • Taxonomy: 282NC2000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 28D0988021
LAB Type Physician Office
Facility Name CHILDREN'S PHYSICIANS-MISSION VILLAGE
Street 16909 Q STREET
City OMAHA
State NE
ZIP 68135
Phone 402 955-7575
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2025
Certificate Expiration Date 12/31/2026
Facility Type Physician Office
Lab Director DR. KELLEN WALSH

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