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You can, but most dealers are ordering cars non-nav standard audio or nav with premium audio. Your best bet is to put a deposit down and special order it the way you want it.
Call around, from what I gathered here in CA they were not selling Premium Audio without nav, when i purchased, so I went with the nav. It was a good decision. However in the east coast they seem to be selling premium audio w/o nav. Info is just from what I read in forums.
Yes, you will have to special order it from the factory through your dealer. Lexus likes to produce cars w/ certain packages in order to maximize efficiency on the assembly line.