28D2100612 CLIA NUMBER - HILLCREST GRAND LODGE, LLC DBA HILLCREST GRAND LODGE

Laboratory Demographics

  • CLIA Code: 28D2100612
  • Facility Name: HILLCREST GRAND LODGE, LLC DBA HILLCREST GRAND LODGE
  • Facility Address: 6021 GRAND LODGE AVENUE
    PAPILLION, NE
    ZIP 68133
  • Facility Phone: 402 885-7100
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MS. ERIN M. EDWARDS
  • NPI Number: 1548925498
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 28D2100612
LAB Type Assisted Living Facility
Facility Name HILLCREST GRAND LODGE, LLC DBA HILLCREST GRAND LODGE
Street 6021 GRAND LODGE AVENUE
City PAPILLION
State NE
ZIP 68133
Phone 402 885-7100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2025
Certificate Expiration Date 8/17/2027
Facility Type Assisted Living Facility
Lab Director MS. ERIN M. EDWARDS

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