28D2296480 CLIA NUMBER - WEST OMAHA DERMATOLOGY, LLC

Laboratory Demographics

  • CLIA Code: 28D2296480
  • Facility Name: WEST OMAHA DERMATOLOGY, LLC
  • Facility Address: 11717 BRYAN STREET, UNIT 105
    GRETNA, NE
    ZIP 68028
  • Facility Phone: 402 281-9080
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAURA CATHERINE C. VARGO
  • NPI Number: 1932889920
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 28D2296480
LAB Type Physician Office
Facility Name WEST OMAHA DERMATOLOGY, LLC
Street 11717 BRYAN STREET, UNIT 105
City GRETNA
State NE
ZIP 68028
Phone 402 281-9080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2023
Certificate Expiration Date 12/28/2025
Facility Type Physician Office
Lab Director LAURA CATHERINE C. VARGO

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