28D2128328 CLIA NUMBER - MYRTLE HEALTH, LLC

Laboratory Demographics

  • CLIA Code: 28D2128328
  • Facility Name: MYRTLE HEALTH, LLC
  • Facility Address: 623 BROADWAY STREET
    IMPERIAL, NE
    ZIP 69033
  • Facility Phone: 308 883-0601
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: DEAUN A. CARPENTER
  • NPI Number: 1134879547
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 28D2128328
LAB Type Practitioner Other
Facility Name MYRTLE HEALTH, LLC
Street 623 BROADWAY STREET
City IMPERIAL
State NE
ZIP 69033
Phone 308 883-0601
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 3/28/2025
Certificate Expiration Date 3/27/2027
Facility Type Practitioner Other
Lab Director DEAUN A. CARPENTER

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