28D2004618 CLIA NUMBER - HERITAGE RIDGE RETIREMENT COMMUNITY

Laboratory Demographics

  • CLIA Code: 28D2004618
  • Facility Name: HERITAGE RIDGE RETIREMENT COMMUNITY
  • Facility Address: 1502 FORT CROOK ROAD SOUTH
    BELLEVUE, NE
    ZIP 68005
  • Facility Phone: 402 932-1881
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MS. SAMANTHA J. NIEMOTH
  • NPI Number: 1275806838
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 28D2004618
LAB Type Assisted Living Facility
Facility Name HERITAGE RIDGE RETIREMENT COMMUNITY
Street 1502 FORT CROOK ROAD SOUTH
City BELLEVUE
State NE
ZIP 68005
Phone 402 932-1881
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2024
Certificate Expiration Date 3/8/2026
Facility Type Assisted Living Facility
Lab Director MS. SAMANTHA J. NIEMOTH

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