49D2143481 CLIA NUMBER - PREMIER ACUTE CARE SERVICES, LLC

Laboratory Demographics

CLIA Number: 49D2143481

Facility Name: PREMIER ACUTE CARE SERVICES, LLC

Facility Address:
11073 COLONEL ARMISTEAD DRIVE - SUITE 105
RUTHER GLEN, VA
ZIP 22546
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Facility Phone Number: 804 220-6044

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1174021752

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	49D2143481
LAB Type	Other - URGENT CARE
Facility Name	PREMIER ACUTE CARE SERVICES, LLC
Street	11073 COLONEL ARMISTEAD DRIVE - SUITE 105
City	RUTHER GLEN
State	VA
ZIP	22546
Phone	804 220-6044
CertificateType	4
CertificateEffectiveDate	7/1/2023
CertificateExpirationDate	6/30/2025
FacilityType	Waiver

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