10D2022642 CLIA NUMBER - PHYSIATRIC PAIN & MEDICAL REHABILITATION CLINIC PA

Laboratory Demographics

  • CLIA Code: 10D2022642
  • Facility Name: PHYSIATRIC PAIN & MEDICAL REHABILITATION CLINIC PA
  • Facility Address: 882 S KIRKMAN RD STE 305
    ORLANDO, FL
    ZIP 32811
  • Facility Phone: 407 291-3077
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NNAMDI C. NWAOGWUGWU
  • NPI Number: 1205012325
  • Taxonomy: 2081P2900X - Physical Medicine & Rehabilitation

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CLIA Record

Field Name Field Value
CLIA Number 10D2022642
LAB Type Physician Office
Facility Name PHYSIATRIC PAIN & MEDICAL REHABILITATION CLINIC PA
Street 882 S KIRKMAN RD STE 305
City ORLANDO
State FL
ZIP 32811
Phone 407 291-3077
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Physician Office
Lab Director NNAMDI C. NWAOGWUGWU

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