36D2191988 CLIA NUMBER - PREMIER COMMUNITY HEALTH DBA PREMIER STUDENT HEALTH UD

Laboratory Demographics

  • CLIA Code: 36D2191988
  • Facility Name: PREMIER COMMUNITY HEALTH DBA PREMIER STUDENT HEALTH UD
  • Facility Address: 1715 BROWN ST, SUITE 300
    DAYTON, OH
    ZIP 45409
  • Facility Phone: 937 276-7665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMANDA D. PULFER
  • NPI Number: 1346801446
  • Taxonomy: 261QX0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D2191988
LAB Type Physician Office
Facility Name PREMIER COMMUNITY HEALTH DBA PREMIER STUDENT HEALTH UD
Street 1715 BROWN ST, SUITE 300
City DAYTON
State OH
ZIP 45409
Phone 937 276-7665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2024
Certificate Expiration Date 9/2/2026
Facility Type Physician Office
Lab Director AMANDA D. PULFER

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