05D2062033 CLIA NUMBER - PREMIUM URGENT CARE

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Laboratory Demographics

CLIA Number: 05D2062033

Facility Name: PREMIUM URGENT CARE

Facility Address:
2021 HERNDON AVE STE 101
CLOVIS, CA
ZIP 93611
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Facility Phone Number: 559 797-4315

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1215455779

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2062033
LAB Type	Physician Office
Facility Name	PREMIUM URGENT CARE
Street	2021 HERNDON AVE STE 101
City	CLOVIS
State	CA
ZIP	93611
Phone	559 797-4315
CertificateType	3
CertificateEffectiveDate	7/9/2023
CertificateExpirationDate	7/8/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024