28D2288007 CLIA NUMBER - CHI HEALTH CLINIC DERMATOLOGY - ELKHORN

Laboratory Demographics

CLIA Number: 28D2288007

Facility Name: CHI HEALTH CLINIC DERMATOLOGY - ELKHORN

Facility Address:
1625 N 205TH STREET
OMAHA, NE
ZIP 68154
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Facility Phone Number: 402 717-0750

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1982773776

Taxonomy: 363L00000X - Nurse Practitioner
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

CLIA Record

Field Name	Field Value
CLIA Number	28D2288007
LAB Type	Physician Office
Facility Name	CHI HEALTH CLINIC DERMATOLOGY - ELKHORN
Street	1625 N 205TH STREET
City	OMAHA
State	NE
ZIP	68154
Phone	402 717-0750
CertificateType	2
CertificateEffectiveDate	12/19/2023
CertificateExpirationDate	12/18/2025
FacilityType	Compliance

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