28D2142364 CLIA NUMBER - PEDXM, PC

Laboratory Demographics

  • CLIA Code: 28D2142364
  • Facility Name: PEDXM, PC
  • Facility Address: 2953 S 168TH STREET SUITE 101
    OMAHA, NE
    ZIP 68130
  • Facility Phone: 402 917-6944
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MS. ERIN E. THOMAN
  • NPI Number: 1043726524
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 28D2142364
LAB Type Practitioner Other
Facility Name PEDXM, PC
Street 2953 S 168TH STREET SUITE 101
City OMAHA
State NE
ZIP 68130
Phone 402 917-6944
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2024
Certificate Expiration Date 1/8/2026
Facility Type Practitioner Other
Lab Director MS. ERIN E. THOMAN

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