10D1096377 CLIA NUMBER - HERNANDO PAIN MGMT

Laboratory Demographics

  • CLIA Code: 10D1096377
  • Facility Name: HERNANDO PAIN MGMT
  • Facility Address: 5193 MARINER BLVD
    SPRING HILL, FL
    ZIP 34609
  • Facility Phone: 352 688-6393
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GEORGE S. SIDHOM
  • NPI Number: 1255351532
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 10D1096377
LAB Type Physician Office
Facility Name HERNANDO PAIN MGMT
Street 5193 MARINER BLVD
City SPRING HILL
State FL
ZIP 34609
Phone 352 688-6393
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2025
Certificate Expiration Date 3/3/2027
Facility Type Physician Office
Lab Director GEORGE S. SIDHOM

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