Provider Demographics
NPI:1871292649
Name:PREMIER LAB & SCREENING LLC
Entity type:Organization
Organization Name:PREMIER LAB & SCREENING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LILLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-961-8774
Mailing Address - Street 1:333 TEXAS ST STE 1300
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-3783
Mailing Address - Country:US
Mailing Address - Phone:866-961-8774
Mailing Address - Fax:318-543-5994
Practice Address - Street 1:333 TEXAS ST STE 1300
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-3783
Practice Address - Country:US
Practice Address - Phone:866-961-8774
Practice Address - Fax:318-543-5994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory