28D1037682 CLIA NUMBER - PALMYRA RESCUE SERVICE

Laboratory Demographics

CLIA Number: 28D1037682

Facility Name: PALMYRA RESCUE SERVICE

Facility Address:
230 W 5TH STREET
PALMYRA, NE
ZIP 68418
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Facility Phone Number: 402 780-5647

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1598774523

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	28D1037682
LAB Type	Ambulance
Facility Name	PALMYRA RESCUE SERVICE
Street	230 W 5TH STREET
City	PALMYRA
State	NE
ZIP	68418
Phone	402 780-5647
CertificateType	4
CertificateEffectiveDate	3/2/2023
CertificateExpirationDate	3/1/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024