15D2337935 CLIA NUMBER - PREMIER VILLAGE PHYSICIANS

Laboratory Demographics

  • CLIA Code: 15D2337935
  • Facility Name: PREMIER VILLAGE PHYSICIANS
  • Facility Address: 12680 LONGLEAF LN
    FISHERS, IN
    ZIP 46038
  • Facility Phone: (317) 777-0628
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: TYLER L. VERNON
  • NPI Number: 1134052053
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 15D2337935
LAB Type Mobile Laboratory
Facility Name PREMIER VILLAGE PHYSICIANS
Street 12680 LONGLEAF LN
City FISHERS
State IN
ZIP 46038
Phone 3177770628
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2026
Certificate Expiration Date 2/2/2028
Facility Type Mobile Laboratory
Lab Director TYLER L. VERNON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/29/2026