36D0714316 CLIA NUMBER - PREMIER HEALTH FAMILY CARE OF VANDALIA

Laboratory Demographics

  • CLIA Code: 36D0714316
  • Facility Name: PREMIER HEALTH FAMILY CARE OF VANDALIA
  • Facility Address: 600 AVIATOR COURT, SUITE 100
    VANDALIA, OH
    ZIP 45377
  • Facility Phone: 937 208-7776
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSEPH P. ALLEN
  • NPI Number: 1902827744
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D0714316
LAB Type Physician Office
Facility Name PREMIER HEALTH FAMILY CARE OF VANDALIA
Street 600 AVIATOR COURT, SUITE 100
City VANDALIA
State OH
ZIP 45377
Phone 937 208-7776
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director JOSEPH P. ALLEN

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