28D2215024 CLIA NUMBER - COLONIAL ESTATES

Laboratory Demographics

  • CLIA Code: 28D2215024
  • Facility Name: COLONIAL ESTATES
  • Facility Address: 811 SOUTH MAIN STREET
    RANDOLPH, NE
    ZIP 68771
  • Facility Phone: 402 337-0444
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DR. SAMUEL RECOB
  • NPI Number: 1639143621
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 28D2215024
LAB Type Assisted Living Facility
Facility Name COLONIAL ESTATES
Street 811 SOUTH MAIN STREET
City RANDOLPH
State NE
ZIP 68771
Phone 402 337-0444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2025
Certificate Expiration Date 2/25/2027
Facility Type Assisted Living Facility
Lab Director DR. SAMUEL RECOB

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