36D1095865 CLIA NUMBER - PREMIER COMMUNITY HEALTH

Laboratory Demographics

  • CLIA Code: 36D1095865
  • Facility Name: PREMIER COMMUNITY HEALTH
  • Facility Address: 3170 KETTERING BLVD
    DAYTON, OH
    ZIP 45439
  • Facility Phone: 937 227-9400
  • Facility Type: Health Fair
  • Facility Type: Waiver
  • Lab Director: LYNN M. FOUBERT
  • NPI Number: 1740842319
  • Taxonomy: 163WC1500X - Registered Nurse

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CLIA Record

Field Name Field Value
CLIA Number 36D1095865
LAB Type Health Fair
Facility Name PREMIER COMMUNITY HEALTH
Street 3170 KETTERING BLVD
City DAYTON
State OH
ZIP 45439
Phone 937 227-9400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/19/2025
Certificate Expiration Date 2/18/2027
Facility Type Health Fair
Lab Director LYNN M. FOUBERT

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