07D2084896 CLIA NUMBER - PREMIER MEDICAL CARE LLC

Laboratory Demographics

  • CLIA Code: 07D2084896
  • Facility Name: PREMIER MEDICAL CARE LLC
  • Facility Address: 340 BROAD ST SUITE 100
    WINDSOR, CT
    ZIP 06095
  • Facility Phone: 860 587-7170
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHNNY C. WRIGHT
  • NPI Number: 1679974521
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 07D2084896
LAB Type Physician Office
Facility Name PREMIER MEDICAL CARE LLC
Street 340 BROAD ST SUITE 100
City WINDSOR
State CT
ZIP 06095
Phone 860 587-7170
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2024
Certificate Expiration Date 10/2/2026
Facility Type Physician Office
Lab Director JOHNNY C. WRIGHT

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