28D1094999 CLIA NUMBER - SOUTHWEST LINCOLN SURGERY CENTER LLC

Laboratory Demographics

CLIA Number: 28D1094999

Facility Name: SOUTHWEST LINCOLN SURGERY CENTER LLC

Facility Address:
WEST MEDICAL PLAZA B 2222 SOUTH 16TH STREET, STE 315
LINCOLN, NE
ZIP 68502
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Facility Phone Number: 402 475-3100

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1053565259

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	28D1094999
LAB Type	Ambulatory Surgery Center
Facility Name	SOUTHWEST LINCOLN SURGERY CENTER LLC
Street	WEST MEDICAL PLAZA B 2222 SOUTH 16TH STREET, STE 315
City	LINCOLN
State	NE
ZIP	68502
Phone	402 475-3100
CertificateType	4
CertificateEffectiveDate	1/30/2023
CertificateExpirationDate	1/29/2025
FacilityType	Waiver

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