28D2167127 CLIA NUMBER - TRANSFORMATIVE HEALTHCARE

Laboratory Demographics

  • CLIA Code: 28D2167127
  • Facility Name: TRANSFORMATIVE HEALTHCARE
  • Facility Address: 11810 NICHOLAS STREET SUITE 102
    OMAHA, NE
    ZIP 68154
  • Facility Phone: 402 307-5510
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CASSIE KRAUSE
  • NPI Number: 1043865165
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 28D2167127
LAB Type Physician Office
Facility Name TRANSFORMATIVE HEALTHCARE
Street 11810 NICHOLAS STREET SUITE 102
City OMAHA
State NE
ZIP 68154
Phone 402 307-5510
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2025
Certificate Expiration Date 6/2/2027
Facility Type Physician Office
Lab Director CASSIE KRAUSE

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