28D2073153 CLIA NUMBER - OMAHA MEDICAL GROUP LLC

Laboratory Demographics

  • CLIA Code: 28D2073153
  • Facility Name: OMAHA MEDICAL GROUP LLC
  • Facility Address: 9015 ARBOR ST STE 144
    OMAHA, NE
    ZIP 68124
  • Facility Phone: 402 588-0678
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. JACQUELINE O. CHANLATTE
  • NPI Number: 1922438829
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 28D2073153
LAB Type Physician Office
Facility Name OMAHA MEDICAL GROUP LLC
Street 9015 ARBOR ST STE 144
City OMAHA
State NE
ZIP 68124
Phone 402 588-0678
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/11/2024
Certificate Expiration Date 2/10/2026
Facility Type Physician Office
Lab Director DR. JACQUELINE O. CHANLATTE

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