05D2019019 CLIA NUMBER - PREMIER HEALTHCARE SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 05D2019019
  • Facility Name: PREMIER HEALTHCARE SERVICES, LLC
  • Facility Address: 950 S BASCOM AVE STE 3113
    SAN JOSE, CA
    ZIP 95128
  • Facility Phone: 408 288-6700
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ROSS MILLER MD
  • NPI Number: 1114246816
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2019019
LAB Type Home Health Agency
Facility Name PREMIER HEALTHCARE SERVICES, LLC
Street 950 S BASCOM AVE STE 3113
City SAN JOSE
State CA
ZIP 95128
Phone 408 288-6700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2025
Certificate Expiration Date 1/19/2027
Facility Type Home Health Agency
Lab Director ROSS MILLER MD

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