28D2142043 CLIA NUMBER - CHILDREN'S NEBRASKA - WEST OMAHA

Laboratory Demographics

  • CLIA Code: 28D2142043
  • Facility Name: CHILDREN'S NEBRASKA - WEST OMAHA
  • Facility Address: 20502 ROOSEVELT STREET
    ELKHORN, NE
    ZIP 68022
  • Facility Phone: 402 955-8000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EARLINE J. EDWARDS
  • NPI Number: 1487988119
  • Taxonomy: 2251P0200X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 28D2142043
LAB Type Physician Office
Facility Name CHILDREN'S NEBRASKA - WEST OMAHA
Street 20502 ROOSEVELT STREET
City ELKHORN
State NE
ZIP 68022
Phone 402 955-8000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/2/2024
Certificate Expiration Date 1/1/2026
Facility Type Physician Office
Lab Director EARLINE J. EDWARDS

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