05D1083858 CLIA NUMBER - ADVANCED PAIN MANAGEMENT INSTITUTE

Laboratory Demographics

CLIA Number: 05D1083858

Facility Name: ADVANCED PAIN MANAGEMENT INSTITUTE

Facility Address:
200 BUTCHER ROAD
VACAVILLE, CA
ZIP 95687
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Facility Phone Number: 707 359-2255

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1740478502

Taxonomy: 207LP2900X - Anesthesiology
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

CLIA Record

Field Name	Field Value
CLIA Number	05D1083858
LAB Type	Physician Office
Facility Name	ADVANCED PAIN MANAGEMENT INSTITUTE
Street	200 BUTCHER ROAD
City	VACAVILLE
State	CA
ZIP	95687
Phone	707 359-2255
CertificateType	4
CertificateEffectiveDate	5/12/2024
CertificateExpirationDate	5/11/2026
FacilityType	Waiver

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