28D1017877 CLIA NUMBER - MATELYN RETIREMENT COMMUNITY

Laboratory Demographics

  • CLIA Code: 28D1017877
  • Facility Name: MATELYN RETIREMENT COMMUNITY
  • Facility Address: 602 O STREET
    ST PAUL, NE
    ZIP 68873
  • Facility Phone: 308 754-6022
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MS. SHELLEY M. FRIEDRICHSEN
  • NPI Number: 1740573294
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 28D1017877
LAB Type Assisted Living Facility
Facility Name MATELYN RETIREMENT COMMUNITY
Street 602 O STREET
City ST PAUL
State NE
ZIP 68873
Phone 308 754-6022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2024
Certificate Expiration Date 2/8/2026
Facility Type Assisted Living Facility
Lab Director MS. SHELLEY M. FRIEDRICHSEN

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