03D1083664 CLIA NUMBER - OMNI DERMATOLOGY INC

Laboratory Demographics

  • CLIA Code: 03D1083664
  • Facility Name: OMNI DERMATOLOGY INC
  • Facility Address: 4801 E MCDOWELL RD STE 150
    PHOENIX, AZ
    ZIP 85008
  • Facility Phone: 602 954-3919
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: ANDREW RACETTE
  • NPI Number: 1669914172
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 03D1083664
LAB Type Physician Office
Facility Name OMNI DERMATOLOGY INC
Street 4801 E MCDOWELL RD STE 150
City PHOENIX
State AZ
ZIP 85008
Phone 602 954-3919
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 6/16/2024
Certificate Expiration Date 6/15/2026
Facility Type Physician Office
Lab Director ANDREW RACETTE

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