36D2216875 CLIA NUMBER - PREMIER COMMUNITY HEALTH DBA PREMIER OCCUPATIONAL HEALTH

Laboratory Demographics

CLIA Number: 36D2216875

Facility Name: PREMIER COMMUNITY HEALTH DBA PREMIER OCCUPATIONAL HEALTH

Facility Address:
998 S DORSET RD
TROY, OH
ZIP 45373
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Facility Phone Number: 937 208-7358

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1477070985

Taxonomy: 261QX0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	36D2216875
LAB Type	Physician Office
Facility Name	PREMIER COMMUNITY HEALTH DBA PREMIER OCCUPATIONAL HEALTH
Street	998 S DORSET RD
City	TROY
State	OH
ZIP	45373
Phone	937 208-7358
CertificateType	4
CertificateEffectiveDate	3/16/2023
CertificateExpirationDate	3/15/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024