03D2283513 CLIA NUMBER - PREMIER OBGYN, LLC

Laboratory Demographics

  • CLIA Code: 03D2283513
  • Facility Name: PREMIER OBGYN, LLC
  • Facility Address: 1300 N 12TH ST STE 620
    PHOENIX, AZ
    ZIP 85006
  • Facility Phone: 602 283-3668
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL J. HERVERY II
  • NPI Number: 1487035382
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 03D2283513
LAB Type Physician Office
Facility Name PREMIER OBGYN, LLC
Street 1300 N 12TH ST STE 620
City PHOENIX
State AZ
ZIP 85006
Phone 602 283-3668
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2025
Certificate Expiration Date 6/7/2027
Facility Type Physician Office
Lab Director MICHAEL J. HERVERY II

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