28D1020256 CLIA NUMBER - PRIME HOME CARE LLC

Laboratory Demographics

  • CLIA Code: 28D1020256
  • Facility Name: PRIME HOME CARE LLC
  • Facility Address: 6818 GROVER ST, SUITE 101
    OMAHA, NE
    ZIP 68106
  • Facility Phone: 402 390-2492
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: TAMMY J. KIRSH
  • NPI Number: 1023041605
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 28D1020256
LAB Type Home Health Agency
Facility Name PRIME HOME CARE LLC
Street 6818 GROVER ST, SUITE 101
City OMAHA
State NE
ZIP 68106
Phone 402 390-2492
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2023
Certificate Expiration Date 12/15/2025
Facility Type Home Health Agency
Lab Director TAMMY J. KIRSH

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