Provider Demographics
NPI:1235016833
Name:PREMIER DIAGNOSTICS LABORATORY LLC
Entity type:Organization
Organization Name:PREMIER DIAGNOSTICS LABORATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WASEEM AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-918-4371
Mailing Address - Street 1:14110 DALLAS PKWY STE 260
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-4326
Mailing Address - Country:US
Mailing Address - Phone:800-601-8374
Mailing Address - Fax:713-510-0773
Practice Address - Street 1:14110 DALLAS PKWY STE 260
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-4326
Practice Address - Country:US
Practice Address - Phone:800-601-8374
Practice Address - Fax:713-510-0773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory