MEDICARE: PRIMER DIAGNOSTICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1780514190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMER DIAGNOSTICS LLC

Provider Business Mailing Address
First Line	:	6110 SIENNA RANCH RD STE 502
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-7225
Country	:	US
Telephone Number	:	346-691-6009
Fax Number	:

Provider Business Practice Location Address
First Line	:	6110 SIENNA RANCH RD STE 502
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-7225
Country	:	US
Telephone Number	:	346-691-6009
Fax Number	:

Authorized Official
Title or Position	:	OPERATIONAL DIRECTOR
Name	:	MR. MOHAMMED SALEH
Credential	:
Telephone Number	:	346-691-6009

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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