05D2305092 CLIA NUMBER - PREMIUM URGENT CARE INC

Laboratory Demographics

  • CLIA Code: 05D2305092
  • Facility Name: PREMIUM URGENT CARE INC
  • Facility Address: 1069 E CHAMPLAIN DR
    FRESNO, CA
    ZIP 93720
  • Facility Phone: 559 797-4315
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: ERICK J. GREEN
  • NPI Number: 1215455779
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2305092
LAB Type Other - URGENT CARE
Facility Name PREMIUM URGENT CARE INC
Street 1069 E CHAMPLAIN DR
City FRESNO
State CA
ZIP 93720
Phone 559 797-4315
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2024
Certificate Expiration Date 5/22/2026
Facility Type Other - URGENT CARE
Lab Director ERICK J. GREEN

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