05D1088757 CLIA NUMBER - PACIFIC PAIN MANAGEMENT

Laboratory Demographics

  • CLIA Code: 05D1088757
  • Facility Name: PACIFIC PAIN MANAGEMENT
  • Facility Address: 1280 S VICTORIA AVE #204
    VENTURA, CA
    ZIP 93003
  • Facility Phone: 805 644-4930
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT D. FREY
  • NPI Number: 1427093137
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1088757
LAB Type Physician Office
Facility Name PACIFIC PAIN MANAGEMENT
Street 1280 S VICTORIA AVE #204
City VENTURA
State CA
ZIP 93003
Phone 805 644-4930
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2024
Certificate Expiration Date 9/2/2026
Facility Type Physician Office
Lab Director ROBERT D. FREY

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This page was last updated on: 9/29/2025