28D1079884 CLIA NUMBER - LAKESIDE ENDOSCOPY CENTER LLC

Laboratory Demographics

  • CLIA Code: 28D1079884
  • Facility Name: LAKESIDE ENDOSCOPY CENTER LLC
  • Facility Address: 17001 LAKESIDE HILLS PLAZA SUITE 201
    OMAHA, NE
    ZIP 68130
  • Facility Phone: 402 614-2300
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. KIMBERLY S. HARMON
  • NPI Number: 1407992241
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 28D1079884
LAB Type Ambulatory Surgery Center
Facility Name LAKESIDE ENDOSCOPY CENTER LLC
Street 17001 LAKESIDE HILLS PLAZA SUITE 201
City OMAHA
State NE
ZIP 68130
Phone 402 614-2300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2024
Certificate Expiration Date 2/7/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. KIMBERLY S. HARMON

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