Pro Omnibus Diagnostic Center LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PRO OMNIBUS DIAGNOSTIC CENTER LLC

Practice address

9442 S Main St Ste 116
Jonesboro, GA 30236-6073

Phone

(678) 545-9195

NPI assigned

Jan 20, 2025

Reactivated

Sep 2, 2026

Last updated

Sep 2, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gary A Clowers Sr.

Title

Owner/Manager

Phone

(678) 545-9195

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1737331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1619788411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9442 S MAIN ST STE 116",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302366073",
            "telephone_number": "678-545-9195",
            "fax_number": "800-863-8054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9442 S MAIN ST STE 116",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302366073",
            "telephone_number": "678-545-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO OMNIBUS DIAGNOSTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-20",
        "last_updated": "2026-09-02",
        "certification_date": "2025-07-01",
        "deactivation_date": "2026-05-01",
        "reactivation_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "CLOWERS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "678-545-9195",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.