28D1104298 CLIA NUMBER - BAKERS PHARMACY #300

Laboratory Demographics

  • CLIA Code: 28D1104298
  • Facility Name: BAKERS PHARMACY #300
  • Facility Address: 3614 TWIN CREEK DRIVE
    BELLEVUE, NE
    ZIP 68123
  • Facility Phone: 402 292-3580
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICKE ROBERTS
  • NPI Number: 1457391278
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D1104298
LAB Type Pharmacy
Facility Name BAKERS PHARMACY #300
Street 3614 TWIN CREEK DRIVE
City BELLEVUE
State NE
ZIP 68123
Phone 402 292-3580
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2025
Certificate Expiration Date 8/30/2027
Facility Type Pharmacy
Lab Director MICKE ROBERTS

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