28D2098084 CLIA NUMBER - SKIN PC DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 28D2098084
  • Facility Name: SKIN PC DERMATOLOGY
  • Facility Address: 1408 VETERANS DRIVE SUITE 100
    ELKHORN, NE
    ZIP 68022
  • Facility Phone: 402 916-5665
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MS. LYNDSEY G. DEGENHARDT
  • NPI Number: 1134410764
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 28D2098084
LAB Type Physician Office
Facility Name SKIN PC DERMATOLOGY
Street 1408 VETERANS DRIVE SUITE 100
City ELKHORN
State NE
ZIP 68022
Phone 402 916-5665
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 6/30/2025
Certificate Expiration Date 6/29/2027
Facility Type Physician Office
Lab Director MS. LYNDSEY G. DEGENHARDT

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