28D1005428 CLIA NUMBER - OFF BROADWAY ASSISTED AND INDEPENDENT LIVING FACILITY

Laboratory Demographics

  • CLIA Code: 28D1005428
  • Facility Name: OFF BROADWAY ASSISTED AND INDEPENDENT LIVING FACILITY
  • Facility Address: 403 SOUTH 1ST AVENUE
    BROKEN BOW, NE
    ZIP 68822
  • Facility Phone: 308 872-2522
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: MS. KAREN K. CONNELY
  • NPI Number: 1669646410
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 28D1005428
LAB Type Other
Facility Name OFF BROADWAY ASSISTED AND INDEPENDENT LIVING FACILITY
Street 403 SOUTH 1ST AVENUE
City BROKEN BOW
State NE
ZIP 68822
Phone 308 872-2522
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/15/2025
Certificate Expiration Date 10/14/2027
Facility Type Other
Lab Director MS. KAREN K. CONNELY

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