05D2312955 CLIA NUMBER - PREMIUM ALLERGY DBA PREMIUM ALLERGY & RESPIRATORY CENTER

Laboratory Demographics

  • CLIA Code: 05D2312955
  • Facility Name: PREMIUM ALLERGY DBA PREMIUM ALLERGY & RESPIRATORY CENTER
  • Facility Address: 1069 E CHAMPLAIN DR STE A
    FRESNO, CA
    ZIP 93720
  • Facility Phone: 559 494-4446
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANGELA SABRY
  • NPI Number: 1497511208
  • Taxonomy: 207RA0201X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2312955
LAB Type Physician Office
Facility Name PREMIUM ALLERGY DBA PREMIUM ALLERGY & RESPIRATORY CENTER
Street 1069 E CHAMPLAIN DR STE A
City FRESNO
State CA
ZIP 93720
Phone 559 494-4446
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2024
Certificate Expiration Date 10/21/2026
Facility Type Physician Office
Lab Director ANGELA SABRY

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