28D2322860 CLIA NUMBER - PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, PC

Laboratory Demographics

  • CLIA Code: 28D2322860
  • Facility Name: PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, PC
  • Facility Address: 4130 PIONEER WOODS DR STE 1
    LINCOLN, NE
    ZIP 68506
  • Facility Phone: 402 489-4700
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: GUSTAVO MACHADO
  • NPI Number: 1255809620
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 28D2322860
LAB Type Ambulatory Surgery Center
Facility Name PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, PC
Street 4130 PIONEER WOODS DR STE 1
City LINCOLN
State NE
ZIP 68506
Phone 402 489-4700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type Ambulatory Surgery Center
Lab Director GUSTAVO MACHADO

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