28D2027991 CLIA NUMBER - GREELEY MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 28D2027991
  • Facility Name: GREELEY MEDICAL CLINIC
  • Facility Address: 109 WEST OCONNOR AVE
    GREELEY, NE
    ZIP 68842
  • Facility Phone: 308 754-4421
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DR. BRENT KEENPORTZ
  • NPI Number: 1396040259
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 28D2027991
LAB Type Rural Health Clinic
Facility Name GREELEY MEDICAL CLINIC
Street 109 WEST OCONNOR AVE
City GREELEY
State NE
ZIP 68842
Phone 308 754-4421
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2025
Certificate Expiration Date 8/4/2027
Facility Type Rural Health Clinic
Lab Director DR. BRENT KEENPORTZ

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