28D2230296 CLIA NUMBER - PLATTSMOUTH HOMETOWN HEALTH, LLC

Laboratory Demographics

CLIA Number: 28D2230296

Facility Name: PLATTSMOUTH HOMETOWN HEALTH, LLC

Facility Address:
306 NORTH 7TH STREET
PLATTSMOUTH, NE
ZIP 68048
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Facility Phone Number: 402 298-5775

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1144805771

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	28D2230296
LAB Type	Practitioner Other
Facility Name	PLATTSMOUTH HOMETOWN HEALTH, LLC
Street	306 NORTH 7TH STREET
City	PLATTSMOUTH
State	NE
ZIP	68048
Phone	402 298-5775
CertificateType	4
CertificateEffectiveDate	7/21/2023
CertificateExpirationDate	7/20/2025
FacilityType	Waiver

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