11D2319556 CLIA NUMBER - PREMIER INTERNAL MEDICINE SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 11D2319556
  • Facility Name: PREMIER INTERNAL MEDICINE SERVICES, LLC
  • Facility Address: 930 NEW HOPE ROAD, SUITE 10
    LAWRENCEVILLE, GA
    ZIP 30045
  • Facility Phone: (517) 755-7519
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SOWMYA BARRELA
  • NPI Number: 1487478251
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D2319556
LAB Type Physician Office
Facility Name PREMIER INTERNAL MEDICINE SERVICES, LLC
Street 930 NEW HOPE ROAD, SUITE 10
City LAWRENCEVILLE
State GA
ZIP 30045
Phone 5177557519
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2025
Certificate Expiration Date 3/3/2027
Facility Type Physician Office
Lab Director SOWMYA BARRELA

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This page was last updated on: 5/18/2026