11D2118667 CLIA NUMBER - OMNI PRIMARY CARE PC

Laboratory Demographics

  • CLIA Code: 11D2118667
  • Facility Name: OMNI PRIMARY CARE PC
  • Facility Address: 750 HAMMOND DRIVE, BLDG 8, SUITE 100
    ATLANTA, GA
    ZIP 30328
  • Facility Phone: 404 400-2255
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHEEKATI VASUNDHARA
  • NPI Number: 1770945362
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 11D2118667
LAB Type Physician Office
Facility Name OMNI PRIMARY CARE PC
Street 750 HAMMOND DRIVE, BLDG 8, SUITE 100
City ATLANTA
State GA
ZIP 30328
Phone 404 400-2255
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2024
Certificate Expiration Date 9/12/2026
Facility Type Physician Office
Lab Director CHEEKATI VASUNDHARA

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