24D2123415 CLIA NUMBER - OMOCARE LLC

Laboratory Demographics

  • CLIA Code: 24D2123415
  • Facility Name: OMOCARE LLC
  • Facility Address: 7708 67TH AVE NORTH
    BROOKLYN PARK, MN
    ZIP 55428
  • Facility Phone: 763 607-4300
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: RAPHAEL T. OMODUNMIJU
  • NPI Number: 1508309451
  • Taxonomy: 251J00000X - Nursing Care

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CLIA Record

Field Name Field Value
CLIA Number 24D2123415
LAB Type Home Health Agency
Facility Name OMOCARE LLC
Street 7708 67TH AVE NORTH
City BROOKLYN PARK
State MN
ZIP 55428
Phone 763 607-4300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Home Health Agency
Lab Director RAPHAEL T. OMODUNMIJU

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