28D2128333 CLIA NUMBER - ST CROIX HOSPICE - OMAHA

Laboratory Demographics

  • CLIA Code: 28D2128333
  • Facility Name: ST CROIX HOSPICE - OMAHA
  • Facility Address: 11422 MIRACLE HILLS DRIVE, SUITE 200
    OMAHA, NE
    ZIP 68154
  • Facility Phone: 402 609-4818
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: JENA FOSDICK
  • NPI Number: 1740553940
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 28D2128333
LAB Type Hospice
Facility Name ST CROIX HOSPICE - OMAHA
Street 11422 MIRACLE HILLS DRIVE, SUITE 200
City OMAHA
State NE
ZIP 68154
Phone 402 609-4818
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2025
Certificate Expiration Date 3/27/2027
Facility Type Hospice
Lab Director JENA FOSDICK

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