28D2093236 CLIA NUMBER - PACIFIC SPRINGS

Laboratory Demographics

  • CLIA Code: 28D2093236
  • Facility Name: PACIFIC SPRINGS
  • Facility Address: 808 SOUTH 173RD COURT
    OMAHA, NE
    ZIP 68118
  • Facility Phone: 402 829-3286
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: NICOLE E. KOENIG
  • NPI Number: 1417968645
  • Taxonomy: 2251X0800X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 28D2093236
LAB Type Assisted Living Facility
Facility Name PACIFIC SPRINGS
Street 808 SOUTH 173RD COURT
City OMAHA
State NE
ZIP 68118
Phone 402 829-3286
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Assisted Living Facility
Lab Director NICOLE E. KOENIG

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