28D1020744 CLIA NUMBER - LEGACY ESTATES

Laboratory Demographics

  • CLIA Code: 28D1020744
  • Facility Name: LEGACY ESTATES
  • Facility Address: 7200 VAN DORN STREET
    LINCOLN, NE
    ZIP 68506
  • Facility Phone: (402) 484-8888
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: AMBER DAVISON-DIETRICH
  • NPI Number: 1548564552
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 28D1020744
LAB Type Assisted Living Facility
Facility Name LEGACY ESTATES
Street 7200 VAN DORN STREET
City LINCOLN
State NE
ZIP 68506
Phone 4024848888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/31/2025
Certificate Expiration Date 12/30/2027
Facility Type Assisted Living Facility
Lab Director AMBER DAVISON-DIETRICH

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This page was last updated on: 5/18/2026