05D0961460 CLIA NUMBER - OMNI WOMENS HEALTH MEDICAL GROUP INC

Laboratory Demographics

CLIA Number: 05D0961460

Facility Name: OMNI WOMENS HEALTH MEDICAL GROUP INC

Facility Address:
3812 N FIRST ST
FRESNO, CA
ZIP 93726
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Facility Phone Number: 559 495-3120

Facility Type: Independent

Certificate Type: Certificate of Compliance

NPI Number: 1467653774

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	05D0961460
LAB Type	Independent
Facility Name	OMNI WOMENS HEALTH MEDICAL GROUP INC
Street	3812 N FIRST ST
City	FRESNO
State	CA
ZIP	93726
Phone	559 495-3120
CertificateType	2
CertificateEffectiveDate	5/31/2020
CertificateExpirationDate	4/30/2024
FacilityType	Compliance

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