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01D1064147 CLIA NUMBER - CENTER FOR PAIN OF MONTGOMERY PC

Laboratory Demographics

CLIA Number: 01D1064147

Facility Name: CENTER FOR PAIN OF MONTGOMERY PC

Facility Address:
2065 E SOUTH BLVD SUITE 401
MONTGOMERY, AL
ZIP 36116
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Facility Phone Number: 334 288-7808

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1225079262

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name Field Value
CLIA Number 01D1064147
LAB Type Physician Office
Facility Name CENTER FOR PAIN OF MONTGOMERY PC
Street 2065 E SOUTH BLVD SUITE 401
City MONTGOMERY
State AL
ZIP 36116
Phone 334 288-7808
CertificateType 4
CertificateEffectiveDate 1/30/2023
CertificateExpirationDate 1/29/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024