10D2009914 CLIA NUMBER - OMEGA HEALTH AND WELLNESS

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Laboratory Demographics

CLIA Number: 10D2009914

Facility Name: OMEGA HEALTH AND WELLNESS

Facility Address:
8461 PERIMETER PARK BLVD, STE 101
JACKSONVILLE, FL
ZIP 32216
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Facility Phone Number: 904 724-5767

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1063895753

Taxonomy: 261QP3300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2009914
LAB Type	Physician Office
Facility Name	OMEGA HEALTH AND WELLNESS
Street	8461 PERIMETER PARK BLVD, STE 101
City	JACKSONVILLE
State	FL
ZIP	32216
Phone	904 724-5767
CertificateType	4
CertificateEffectiveDate	7/16/2022
CertificateExpirationDate	7/15/2024
FacilityType	Waiver

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