28D1076062 CLIA NUMBER - WITTER FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 28D1076062

Facility Name: WITTER FAMILY MEDICINE

Facility Address:
358 SOUTH 10TH
DAVID CITY, NE
ZIP 68632
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Facility Phone Number: 402 367-3322

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1003949199

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	28D1076062
LAB Type	Rural Health Clinic
Facility Name	WITTER FAMILY MEDICINE
Street	358 SOUTH 10TH
City	DAVID CITY
State	NE
ZIP	68632
Phone	402 367-3322
CertificateType	4
CertificateEffectiveDate	11/5/2023
CertificateExpirationDate	11/4/2025
FacilityType	Waiver

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