45D2171093 CLIA NUMBER - PREMIER CARE GROUP INC

Laboratory Demographics

  • CLIA Code: 45D2171093
  • Facility Name: PREMIER CARE GROUP INC
  • Facility Address: 12808 W AIRPORT BLVD SUITE 346
    SUGAR LAND, TX
    ZIP 77478
  • Facility Phone: 832 917-1704
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: BOMBATA KAFAYATU
  • NPI Number: 1881137800
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D2171093
LAB Type Hospice
Facility Name PREMIER CARE GROUP INC
Street 12808 W AIRPORT BLVD SUITE 346
City SUGAR LAND
State TX
ZIP 77478
Phone 832 917-1704
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2025
Certificate Expiration Date 8/25/2027
Facility Type Hospice
Lab Director BOMBATA KAFAYATU

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