28D2028625 CLIA NUMBER - BAKER'S PHARMACY #301

Laboratory Demographics

  • CLIA Code: 28D2028625
  • Facility Name: BAKER'S PHARMACY #301
  • Facility Address: 4405 N 72ND STREET
    OMAHA, NE
    ZIP 68134
  • Facility Phone: 402 571-3122
  • Facility Type: Other - RETAIL PHARMACY
  • Facility Type: Waiver
  • Lab Director: MR. MICKE ROBERTS
  • NPI Number: 1114968013
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2028625
LAB Type Other - RETAIL PHARMACY
Facility Name BAKER'S PHARMACY #301
Street 4405 N 72ND STREET
City OMAHA
State NE
ZIP 68134
Phone 402 571-3122
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2025
Certificate Expiration Date 8/18/2027
Facility Type Other - RETAIL PHARMACY
Lab Director MR. MICKE ROBERTS

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