28D2326035 CLIA NUMBER - AM WELLNESS CLINIC LLC

Laboratory Demographics

  • CLIA Code: 28D2326035
  • Facility Name: AM WELLNESS CLINIC LLC
  • Facility Address: 1002 MAIN STREET
    BRIDGEPORT, NE
    ZIP 69336
  • Facility Phone: 308 262-5640
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMBER E. MALCOLM
  • NPI Number: 1942195797
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 28D2326035
LAB Type Pharmacy
Facility Name AM WELLNESS CLINIC LLC
Street 1002 MAIN STREET
City BRIDGEPORT
State NE
ZIP 69336
Phone 308 262-5640
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2025
Certificate Expiration Date 6/24/2027
Facility Type Pharmacy
Lab Director AMBER E. MALCOLM

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