28D2034439 CLIA NUMBER - MOSAIC OMAHA PAPILLION ICF/ID

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Field Name	Field Value
CLIA Number	28D2034439
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	MOSAIC OMAHA PAPILLION ICF/ID
Street	1433 GRANDVIEW AVE
City	PAPILLION
State	NE
ZIP	68046
Phone	402 896-9988
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	12/23/2023
Certificate Expiration Date	12/22/2025
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	MOLLY A. FLECK

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