05D2106361 CLIA NUMBER - PREMIUM URGENT CARE INC

Laboratory Demographics

  • CLIA Code: 05D2106361
  • Facility Name: PREMIUM URGENT CARE INC
  • Facility Address: 6643 N MILBURN AVE STE 104
    FRESNO, CA
    ZIP 93722
  • Facility Phone: 559 412-2535
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: ERICK GREEN
  • NPI Number: 1821473935
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2106361
LAB Type Other - URGENT CARE
Facility Name PREMIUM URGENT CARE INC
Street 6643 N MILBURN AVE STE 104
City FRESNO
State CA
ZIP 93722
Phone 559 412-2535
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2023
Certificate Expiration Date 12/17/2025
Facility Type Other - URGENT CARE
Lab Director ERICK GREEN

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