28D1066177 CLIA NUMBER - FULMER PHARMACY

Laboratory Demographics

  • CLIA Code: 28D1066177
  • Facility Name: FULMER PHARMACY
  • Facility Address: 1317 HILL STREET
    HOLDREGE, NE
    ZIP 68949
  • Facility Phone: 308 995-4401
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAUL J. FULMER
  • NPI Number: 1730263377
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D1066177
LAB Type Pharmacy
Facility Name FULMER PHARMACY
Street 1317 HILL STREET
City HOLDREGE
State NE
ZIP 68949
Phone 308 995-4401
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Pharmacy
Lab Director PAUL J. FULMER

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