10D2166104 CLIA NUMBER - PREMIER MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 10D2166104
  • Facility Name: PREMIER MEDICAL GROUP
  • Facility Address: 14065 TOWN LOOP BOULEVARD SUITE 300
    ORLANDO, FL
    ZIP 32837
  • Facility Phone: 407 735-2114
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSE D. SUAREZ
  • NPI Number: 1063067643
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 10D2166104
LAB Type Physician Office
Facility Name PREMIER MEDICAL GROUP
Street 14065 TOWN LOOP BOULEVARD SUITE 300
City ORLANDO
State FL
ZIP 32837
Phone 407 735-2114
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2025
Certificate Expiration Date 5/12/2027
Facility Type Physician Office
Lab Director JOSE D. SUAREZ

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