28D2010661 CLIA NUMBER - PRAIRIE PINES LODGE ASSISTED LIVING

Laboratory Demographics

  • CLIA Code: 28D2010661
  • Facility Name: PRAIRIE PINES LODGE ASSISTED LIVING
  • Facility Address: 900 WEST 7TH STREET
    CHADRON, NE
    ZIP 69337
  • Facility Phone: 308 432-4305
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MR. TIMOTHY C. FRYE
  • NPI Number: 1700908167
  • Taxonomy: 282NC0060X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 28D2010661
LAB Type Assisted Living Facility
Facility Name PRAIRIE PINES LODGE ASSISTED LIVING
Street 900 WEST 7TH STREET
City CHADRON
State NE
ZIP 69337
Phone 308 432-4305
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2024
Certificate Expiration Date 8/1/2026
Facility Type Assisted Living Facility
Lab Director MR. TIMOTHY C. FRYE

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