28D2034454 CLIA NUMBER - OMAHA HARRISON DIALYSIS

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Laboratory Demographics

CLIA Number: 28D2034454

Facility Name: OMAHA HARRISON DIALYSIS

Facility Address:
6610 SOUTH 168TH STREET, SUITE 8
OMAHA, NE
ZIP 68135
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Facility Phone Number: 402 896-4609

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1760766984

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	28D2034454
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	OMAHA HARRISON DIALYSIS
Street	6610 SOUTH 168TH STREET, SUITE 8
City	OMAHA
State	NE
ZIP	68135
Phone	402 896-4609
CertificateType	4
CertificateEffectiveDate	12/23/2023
CertificateExpirationDate	12/22/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024