03D2112434 CLIA NUMBER - PREMIER ONE HOME CARE, LLC

Laboratory Demographics

  • CLIA Code: 03D2112434
  • Facility Name: PREMIER ONE HOME CARE, LLC
  • Facility Address: 931 E SOUTHERN AVE, #107
    MESA, AZ
    ZIP 85204
  • Facility Phone: 480 773-6837
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: SATYA D. MUDHAR
  • NPI Number: 1982154076
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 03D2112434
LAB Type Home Health Agency
Facility Name PREMIER ONE HOME CARE, LLC
Street 931 E SOUTHERN AVE, #107
City MESA
State AZ
ZIP 85204
Phone 480 773-6837
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2024
Certificate Expiration Date 4/27/2026
Facility Type Home Health Agency
Lab Director SATYA D. MUDHAR

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This page was last updated on: 6/4/2025