28D2140630 CLIA NUMBER - COUNTRY LANE RETIREMENT VILLAGE

Laboratory Demographics

  • CLIA Code: 28D2140630
  • Facility Name: COUNTRY LANE RETIREMENT VILLAGE
  • Facility Address: 1203 E HYNES
    O' NEILL, NE
    ZIP 68763
  • Facility Phone: 402 961-1358
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MS. STEPHANIE FRITZ
  • NPI Number: 1962919472
  • Taxonomy: 311500000X - Alzheimer Center (Dementia Center)

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 28D2140630
LAB Type Assisted Living Facility
Facility Name COUNTRY LANE RETIREMENT VILLAGE
Street 1203 E HYNES
City O' NEILL
State NE
ZIP 68763
Phone 402 961-1358
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/27/2023
Certificate Expiration Date 11/26/2025
Facility Type Assisted Living Facility
Lab Director MS. STEPHANIE FRITZ

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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