10D2013771 CLIA NUMBER - FLORIDA INTERVENTIONAL PAIN MANAGEMENT

Laboratory Demographics

  • CLIA Code: 10D2013771
  • Facility Name: FLORIDA INTERVENTIONAL PAIN MANAGEMENT
  • Facility Address: 1447 MEDICAL PARK BLVD SUITE 209
    WELLINGTON, FL
    ZIP 33414
  • Facility Phone: 561 537-4817
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LISA BANIONIS
  • NPI Number: 1164687778
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2013771
LAB Type Physician Office
Facility Name FLORIDA INTERVENTIONAL PAIN MANAGEMENT
Street 1447 MEDICAL PARK BLVD SUITE 209
City WELLINGTON
State FL
ZIP 33414
Phone 561 537-4817
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Physician Office
Lab Director LISA BANIONIS

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