28D2115124 CLIA NUMBER - COUNTRYHOUSE RESIDENCES

Laboratory Demographics

CLIA Number: 28D2115124

Facility Name: COUNTRYHOUSE RESIDENCES

Facility Address:
240 SOUTH 70TH
LINCOLN, NE
ZIP 68510
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Facility Phone Number: 402 421-2200

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1477077808

Taxonomy: 251J00000X - Nursing Care
A Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services.

CLIA Record

Field Name	Field Value
CLIA Number	28D2115124
LAB Type	Assisted Living Facility
Facility Name	COUNTRYHOUSE RESIDENCES
Street	240 SOUTH 70TH
City	LINCOLN
State	NE
ZIP	68510
Phone	402 421-2200
CertificateType	4
CertificateEffectiveDate	6/28/2022
CertificateExpirationDate	6/27/2024
FacilityType	Waiver

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