05D2085484 CLIA NUMBER - PREMIER HEALTHCARE SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 05D2085484
  • Facility Name: PREMIER HEALTHCARE SERVICES, LLC
  • Facility Address: 2937 VENEMAN AVE STE A-100
    MODESTO, CA
    ZIP 95356
  • Facility Phone: 209 408-1344
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: ROSS MILLER, MD
  • NPI Number: 1790198968
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 05D2085484
LAB Type Home Health Agency
Facility Name PREMIER HEALTHCARE SERVICES, LLC
Street 2937 VENEMAN AVE STE A-100
City MODESTO
State CA
ZIP 95356
Phone 209 408-1344
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/15/2024
Certificate Expiration Date 10/14/2026
Facility Type Home Health Agency
Lab Director ROSS MILLER, MD

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