11D2273249 CLIA NUMBER - OMS PRIMARY CARE INC

Laboratory Demographics

  • CLIA Code: 11D2273249
  • Facility Name: OMS PRIMARY CARE INC
  • Facility Address: 2145 ROSWELL ROAD, SUITE 60
    MARIETTA, GA
    ZIP 30062
  • Facility Phone: 770 672-6267
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OMOKHUALE OMOKHODION
  • NPI Number: 1063123933
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2273249
LAB Type Physician Office
Facility Name OMS PRIMARY CARE INC
Street 2145 ROSWELL ROAD, SUITE 60
City MARIETTA
State GA
ZIP 30062
Phone 770 672-6267
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2024
Certificate Expiration Date 12/8/2026
Facility Type Physician Office
Lab Director OMOKHUALE OMOKHODION

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