10D1025852 CLIA NUMBER - PREMIER OBGYN LLC

Laboratory Demographics

  • CLIA Code: 10D1025852
  • Facility Name: PREMIER OBGYN LLC
  • Facility Address: 5323 4TH AVE CIR E
    BRADENTON, FL
    ZIP 34208
  • Facility Phone: 561 300-2410
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. AARON M. SUDBURY
  • NPI Number: 1164460143
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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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
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/18/2024
Certificate Expiration Date 10/17/2026
Facility Type Physician Office
Lab Director DR. AARON M. SUDBURY

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