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

Laboratory Demographics

CLIA Number: 28D2184775

Facility Name: REGIONAL WEST PHYSICIAN'S CLINIC - FAMILY MEDICINE

Facility Address:
3911 AVENUE B - SUITE 1100
SCOTTSBLUFF, NE
ZIP 69361
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Facility Phone Number: 308 630-2100

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1285912030

Taxonomy: 207RE0101X - Internal Medicine
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

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
CertificateType 4
CertificateEffectiveDate 5/26/2022
CertificateExpirationDate 5/25/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024