28D2199220 CLIA NUMBER - BP INC DBA MEDICINE MAN PHARMACY

Laboratory Demographics

  • CLIA Code: 28D2199220
  • Facility Name: BP INC DBA MEDICINE MAN PHARMACY
  • Facility Address: 15615 PACIFIC ST STE 8
    OMAHA, NE
    ZIP 68118
  • Facility Phone: 402 496-9757
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JED L. LEWIS
  • NPI Number: 1851448898
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2199220
LAB Type Pharmacy
Facility Name BP INC DBA MEDICINE MAN PHARMACY
Street 15615 PACIFIC ST STE 8
City OMAHA
State NE
ZIP 68118
Phone 402 496-9757
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2024
Certificate Expiration Date 11/5/2026
Facility Type Pharmacy
Lab Director JED L. LEWIS

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