05D0918896 CLIA NUMBER - OMNI FAMILY HEALTH

Laboratory Demographics

CLIA Number: 05D0918896

Facility Name: OMNI FAMILY HEALTH

Facility Address:
277 E FRONT ST
BUTTONWILLOW, CA
ZIP 93206
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Facility Phone Number: 661 459-1900

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1245777358

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0918896
LAB Type	Federally Qualified Health Center
Facility Name	OMNI FAMILY HEALTH
Street	277 E FRONT ST
City	BUTTONWILLOW
State	CA
ZIP	93206
Phone	661 459-1900
CertificateType	4
CertificateEffectiveDate	7/12/2022
CertificateExpirationDate	7/11/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024