10D2015201 CLIA NUMBER - PAIN CARE MANAGEMENT OF CLEARWATER LLC PAIN CARE OF CLEARWATER

Laboratory Demographics

  • CLIA Code: 10D2015201
  • Facility Name: PAIN CARE MANAGEMENT OF CLEARWATER LLC PAIN CARE OF CLEARWATER
  • Facility Address: 51 S MAIN AVE STE 318
    CLEARWATER, FL
    ZIP 33765
  • Facility Phone: 727 572-6261
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALEXIS P. HENDERSON
  • NPI Number: 1790094829
  • Taxonomy: 261QP3300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2015201
LAB Type Physician Office
Facility Name PAIN CARE MANAGEMENT OF CLEARWATER LLC PAIN CARE OF CLEARWATER
Street 51 S MAIN AVE STE 318
City CLEARWATER
State FL
ZIP 33765
Phone 727 572-6261
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2024
Certificate Expiration Date 10/24/2026
Facility Type Physician Office
Lab Director ALEXIS P. HENDERSON

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This page was last updated on: 3/20/2025