05D2000867 CLIA NUMBER - OMEGA HOUSE

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CLIA Record

Field Name Field Value
CLIA Number 05D2000867
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name OMEGA HOUSE
Street 7830 OMEGA WAY
City STOCKTON
State CA
ZIP 95212
Phone 209 954-0428
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2023
Certificate Expiration Date 12/7/2025
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director PAK CHAN

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