Premier 1 Labs , LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PREMIER 1 LABS , LLC

Practice address

535 S Nolen Dr Ste 100
Southlake, TX 76092-9194

Phone

(682) 477-4014

Fax

(682) 477-4038

NPI assigned

Feb 6, 2022

Organization subpart

No

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

Authorized official

Name

Chantal L Swart

Title

Authorized Official

Phone

(682) 477-4014

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1644105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644105600000",
    "number": "1710631049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 S NOLEN DR STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929194",
            "telephone_number": "682-477-4014",
            "fax_number": "682-477-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S NOLEN DR STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760929194",
            "telephone_number": "682-477-4014",
            "fax_number": "682-477-4038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER 1 LABS , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-06",
        "last_updated": "2022-02-06",
        "certification_date": "2022-02-06",
        "status": "A",
        "authorized_official_last_name": "SWART",
        "authorized_official_first_name": "CHANTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "682-477-4014"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D2251727",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Southlake, TX
• Providers in Southlake, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.