28D1011542 CLIA NUMBER - BAKER'S PHARMACY #302

Laboratory Demographics

  • CLIA Code: 28D1011542
  • Facility Name: BAKER'S PHARMACY #302
  • Facility Address: 12025 WEST CENTER RD
    OMAHA, NE
    ZIP 68144
  • Facility Phone: 402 333-6500
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICKE ROBERTS
  • NPI Number: 1548200363
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D1011542
LAB Type Pharmacy
Facility Name BAKER'S PHARMACY #302
Street 12025 WEST CENTER RD
City OMAHA
State NE
ZIP 68144
Phone 402 333-6500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Pharmacy
Lab Director MICKE ROBERTS

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