36D1043355 CLIA NUMBER - PREMIUM PEDIATRICS INC

Laboratory Demographics

  • CLIA Code: 36D1043355
  • Facility Name: PREMIUM PEDIATRICS INC
  • Facility Address: 918 YOUNGSTOWN WARREN ROAD SUITE C
    NILES, OH
    ZIP 44446
  • Facility Phone: 330 652-3100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TERESA YOCUM
  • NPI Number: 1497730550
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 36D1043355
LAB Type Physician Office
Facility Name PREMIUM PEDIATRICS INC
Street 918 YOUNGSTOWN WARREN ROAD SUITE C
City NILES
State OH
ZIP 44446
Phone 330 652-3100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2025
Certificate Expiration Date 7/20/2027
Facility Type Physician Office
Lab Director TERESA YOCUM

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