28D2308782 CLIA NUMBER - FULTON HOMES LABS

Laboratory Demographics

  • CLIA Code: 28D2308782
  • Facility Name: FULTON HOMES LABS
  • Facility Address: 13750 MILLARD AVE SUITE 150
    OMAHA, NE
    ZIP 68137
  • Facility Phone: 402 502-0502
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: DEMERIA M. BRUCE
  • NPI Number: 1881487072
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 28D2308782
LAB Type Independent
Facility Name FULTON HOMES LABS
Street 13750 MILLARD AVE SUITE 150
City OMAHA
State NE
ZIP 68137
Phone 402 502-0502
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2024
Certificate Expiration Date 8/1/2026
Facility Type Independent
Lab Director DEMERIA M. BRUCE

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