10D2271625 CLIA NUMBER - PREMIER INTERVENTIONAL & DIAGNOSTIC RADIOLOGY CORP DBA PREMIER VASCULAR

Laboratory Demographics

  • CLIA Code: 10D2271625
  • Facility Name: PREMIER INTERVENTIONAL & DIAGNOSTIC RADIOLOGY CORP DBA PREMIER VASCULAR
  • Facility Address: 4205 W ATLANTIC AVENUE BUILDING A
    BOYNTON BEACH, FL
    ZIP 33435
  • Facility Phone: 561 894-1370
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EMILIO LOPEZ
  • NPI Number: 1801437041
  • Taxonomy: 2085R0204X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2271625
LAB Type Physician Office
Facility Name PREMIER INTERVENTIONAL & DIAGNOSTIC RADIOLOGY CORP DBA PREMIER VASCULAR
Street 4205 W ATLANTIC AVENUE BUILDING A
City BOYNTON BEACH
State FL
ZIP 33435
Phone 561 894-1370
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2024
Certificate Expiration Date 11/3/2026
Facility Type Physician Office
Lab Director EMILIO LOPEZ

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