10D2300444 CLIA NUMBER - PREMIERE GI PLLC

Laboratory Demographics

  • CLIA Code: 10D2300444
  • Facility Name: PREMIERE GI PLLC
  • Facility Address: 11505 PALMBRUSH TRAIL SUITE 200
    LAKEWOOD RANCH, FL
    ZIP 34202
  • Facility Phone: 941 334-9040
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ARUN KHAZANCHI
  • NPI Number: 1336829894
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2300444
LAB Type Physician Office
Facility Name PREMIERE GI PLLC
Street 11505 PALMBRUSH TRAIL SUITE 200
City LAKEWOOD RANCH
State FL
ZIP 34202
Phone 941 334-9040
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 3/11/2024
Certificate Expiration Date 3/10/2026
Facility Type Physician Office
Lab Director ARUN KHAZANCHI

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