Premier Biotech Labs, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

24D2065288 Issued in MN

Legal business name

PREMIER BIOTECH LABS, LLC

Practice address

723 Kasota Ave SE
Minneapolis, MN 55414-2842

Phone

(855) 718-6917

NPI assigned

Oct 17, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Matthew James Michalik

Title

Cfo

Phone

(612) 432-6630

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683417600000",
    "number": "1700280971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 KASOTA AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55414",
            "telephone_number": "855-718-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 KASOTA AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142842",
            "telephone_number": "855-718-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER BIOTECH LABS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2023-05-07",
        "certification_date": "2023-05-07",
        "status": "A",
        "authorized_official_last_name": "MICHALIK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "612-432-6630"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MN",
            "license": "24D2065288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Preferred Care Services Inc
• Kenneth F Preimesberger, M.D.
• Frances Lee Prekker, MD
• Matthew Erren Prekker, MD MPH
• Premeir Home Healthcare
• Premier Care LLC
• Premier Health LLC
• Premier Health of South Minneapolis LTD
• Premier Health Pca Services Inc
• Premier Health Services Inc

• Clinical Medical Laboratory in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Medical Laboratory in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.