10D1053251 CLIA NUMBER - PREMIER PAIN SPECIALISTS LLC

Laboratory Demographics

CLIA Number: 10D1053251

Facility Name: PREMIER PAIN SPECIALISTS LLC

Facility Address:
1228 SE 8TH TERRACE
CAPE CORAL, FL
ZIP 33990
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Facility Phone Number: 239 945-1105

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1962589671

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	10D1053251
LAB Type	Physician Office
Facility Name	PREMIER PAIN SPECIALISTS LLC
Street	1228 SE 8TH TERRACE
City	CAPE CORAL
State	FL
ZIP	33990
Phone	239 945-1105
CertificateType	4
CertificateEffectiveDate	4/19/2024
CertificateExpirationDate	4/18/2026
FacilityType	Waiver

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