34D0981585 CLIA NUMBER - OMNI CLINIC PA

Laboratory Demographics

  • CLIA Code: 34D0981585
  • Facility Name: OMNI CLINIC PA
  • Facility Address: 22 OFFICE PARK DRIVE
    JACKSONVILLE, NC
    ZIP 28546
  • Facility Phone: 910 219-4070
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IBIKUNLE A. OJEBUOBOH
  • NPI Number: 1790748960
  • Taxonomy: 302F00000X - Exclusive Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 34D0981585
LAB Type Physician Office
Facility Name OMNI CLINIC PA
Street 22 OFFICE PARK DRIVE
City JACKSONVILLE
State NC
ZIP 28546
Phone 910 219-4070
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/2/2025
Certificate Expiration Date 1/1/2027
Facility Type Physician Office
Lab Director IBIKUNLE A. OJEBUOBOH

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