10D1025852 CLIA NUMBER - PREMIER OBGYN LLC

Laboratory Demographics

CLIA Number: 10D1025852

Facility Name: PREMIER OBGYN LLC

Facility Address:
5323 4TH AVE CIR E
BRADENTON, FL
ZIP 34208
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Facility Phone Number: 561 300-2410

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1164460143

Taxonomy: 207V00000X - Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

CLIA Record

Field Name	Field Value
CLIA Number	10D1025852
LAB Type	Physician Office
Facility Name	PREMIER OBGYN LLC
Street	5323 4TH AVE CIR E
City	BRADENTON
State	FL
ZIP	34208
Phone	561 300-2410
CertificateType	3
CertificateEffectiveDate	10/18/2022
CertificateExpirationDate	10/17/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024