28D2184775 CLIA NUMBER - REGIONAL WEST PHYSICIAN'S CLINIC - FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 28D2184775
  • Facility Name: REGIONAL WEST PHYSICIAN'S CLINIC - FAMILY MEDICINE
  • Facility Address: 3911 AVENUE B - SUITE 1100
    SCOTTSBLUFF, NE
    ZIP 69361
  • Facility Phone: 308 630-2100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANN L. COURTIER
  • NPI Number: 1285912030
  • Taxonomy: 207RE0101X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 28D2184775
LAB Type Physician Office
Facility Name REGIONAL WEST PHYSICIAN'S CLINIC - FAMILY MEDICINE
Street 3911 AVENUE B - SUITE 1100
City SCOTTSBLUFF
State NE
ZIP 69361
Phone 308 630-2100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2024
Certificate Expiration Date 5/25/2026
Facility Type Physician Office
Lab Director ANN L. COURTIER

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