Organization
OMNI DIAGNOSTIC LABORATORY LLC
Active
Organization
OMNI DIAGNOSTIC LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AHSAN BASEER (CEO)
(714) 493-1224
Entity
Organization
Contact information
Practice address
1888 W 6TH ST STE H, CORONA, CA 92882-2993
(714) 493-1224
(951) 547-4416
Mailing address
1888 W 6TH ST STE H, CORONA, CA 92882-2993
(714) 493-1224
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2128426
CMS CLIA ID
CA
01
—
CLM-00350523
LABORATORY LICENSE
CA
Enumeration date
02/16/2022
Last updated
02/16/2022
Update your record
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