05D2253004 CLIA NUMBER - PREMIUM URGENT CARE

Laboratory Demographics

  • CLIA Code: 05D2253004
  • Facility Name: PREMIUM URGENT CARE
  • Facility Address: 565 W SHAW AVE SUITE B
    CLOVIS, CA
    ZIP 93612
  • Facility Phone: 559 475-9750
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: ERICK GREEN
  • NPI Number: 1386229896
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2253004
LAB Type Other - URGENT CARE
Facility Name PREMIUM URGENT CARE
Street 565 W SHAW AVE SUITE B
City CLOVIS
State CA
ZIP 93612
Phone 559 475-9750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/16/2024
Certificate Expiration Date 2/15/2026
Facility Type Other - URGENT CARE
Lab Director ERICK GREEN

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