28D2218963 CLIA NUMBER - NEBRASKA CVS PHARMACY, LLC DBA CVS/PHARMACY #00473

Laboratory Demographics

  • CLIA Code: 28D2218963
  • Facility Name: NEBRASKA CVS PHARMACY, LLC DBA CVS/PHARMACY #00473
  • Facility Address: 1550 SOUTH ST
    LINCOLN, NE
    ZIP 68502
  • Facility Phone: 401 770-6431
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DUSTIN GRAU
  • NPI Number: 1679869267
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2218963
LAB Type Pharmacy
Facility Name NEBRASKA CVS PHARMACY, LLC DBA CVS/PHARMACY #00473
Street 1550 SOUTH ST
City LINCOLN
State NE
ZIP 68502
Phone 401 770-6431
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Pharmacy
Lab Director DUSTIN GRAU

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