36D2031494 CLIA NUMBER - PREMIER INTERNAL MEDICINE LLC

Laboratory Demographics

  • CLIA Code: 36D2031494
  • Facility Name: PREMIER INTERNAL MEDICINE LLC
  • Facility Address: 6400 E BROAD ST STE 200
    COLUMBUS, OH
    ZIP 43213
  • Facility Phone: 614 861-0967
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN JOHNSON
  • NPI Number: 1790069698
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 36D2031494
LAB Type Physician Office
Facility Name PREMIER INTERNAL MEDICINE LLC
Street 6400 E BROAD ST STE 200
City COLUMBUS
State OH
ZIP 43213
Phone 614 861-0967
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2023
Certificate Expiration Date 10/19/2025
Facility Type Physician Office
Lab Director JOHN JOHNSON

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