03D2101446 CLIA NUMBER - Omni Dermatology, Inc

Laboratory Demographics

CLIA Number: 03D2101446

Facility Name: Omni Dermatology, Inc

Facility Address:
4515 S Mcclintock Dr Ste 101
Tempe, AZ
ZIP 85282
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Facility Phone Number: (602) 559-5470

Facility Type: PHYSICIAN OFFICE

Certificate Type: Certificate of Compliance

NPI Number: 1639611130

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	03D2101446
LAB Type	PHYSICIAN OFFICE
Facility Name	Omni Dermatology, Inc
Street	4515 S Mcclintock Dr Ste 101
City	Tempe
State	AZ
ZIP	85282
Phone	(602) 559-5470

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This page was last updated on: 4/7/2021