28D2294131 CLIA NUMBER - TRUE NORTH MEDICAL LLC

Laboratory Demographics

  • CLIA Code: 28D2294131
  • Facility Name: TRUE NORTH MEDICAL LLC
  • Facility Address: 212 N GREEN ST
    CLARKS, NE
    ZIP 68628
  • Facility Phone: 402 366-0872
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: BRADY W. HANQUIST
  • NPI Number: 1205604766
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 28D2294131
LAB Type Practitioner Other
Facility Name TRUE NORTH MEDICAL LLC
Street 212 N GREEN ST
City CLARKS
State NE
ZIP 68628
Phone 402 366-0872
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2023
Certificate Expiration Date 11/19/2025
Facility Type Practitioner Other
Lab Director BRADY W. HANQUIST

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