42D0956299 CLIA NUMBER - PREMIER CLINICS PA

Laboratory Demographics

  • CLIA Code: 42D0956299
  • Facility Name: PREMIER CLINICS PA
  • Facility Address: 225 S HERLONG AVE
    ROCK HILL, SC
    ZIP 29732
  • Facility Phone: 704 258-9400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BAMIDELE A. EKUNSANMI
  • NPI Number: 1124307624
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 42D0956299
LAB Type Physician Office
Facility Name PREMIER CLINICS PA
Street 225 S HERLONG AVE
City ROCK HILL
State SC
ZIP 29732
Phone 704 258-9400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/16/2024
Certificate Expiration Date 2/15/2026
Facility Type Physician Office
Lab Director BAMIDELE A. EKUNSANMI

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