10D2249883 CLIA NUMBER - PREMIER HEALTH PLUS, LLC

Laboratory Demographics

  • CLIA Code: 10D2249883
  • Facility Name: PREMIER HEALTH PLUS, LLC
  • Facility Address: 3691 TAMIAMI TRAIL
    PUNTA GORDA, FL
    ZIP 33950
  • Facility Phone: 239 810-1859
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JERRY HERNANDEZ
  • NPI Number: 1043972102
  • Taxonomy: 363LP2300X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2249883
LAB Type Physician Office
Facility Name PREMIER HEALTH PLUS, LLC
Street 3691 TAMIAMI TRAIL
City PUNTA GORDA
State FL
ZIP 33950
Phone 239 810-1859
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2024
Certificate Expiration Date 1/23/2026
Facility Type Physician Office
Lab Director JERRY HERNANDEZ

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