28D1050381 CLIA NUMBER - ADVANCED SURGERY CENTER LLC

Laboratory Demographics

CLIA Number: 28D1050381

Facility Name: ADVANCED SURGERY CENTER LLC

Facility Address:
111 S 10TH STREET
OMAHA, NE
ZIP 68102
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Facility Phone Number: 402 345-1712

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1053366930

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	28D1050381
LAB Type	Ambulatory Surgery Center
Facility Name	ADVANCED SURGERY CENTER LLC
Street	111 S 10TH STREET
City	OMAHA
State	NE
ZIP	68102
Phone	402 345-1712
CertificateType	4
CertificateEffectiveDate	2/1/2024
CertificateExpirationDate	1/31/2026
FacilityType	Waiver

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