10D2082720 CLIA NUMBER - RIVERCOAST PAIN MANAGEMENT

Laboratory Demographics

  • CLIA Code: 10D2082720
  • Facility Name: RIVERCOAST PAIN MANAGEMENT
  • Facility Address: 1899 MURRELL RD STE 130
    ROCKLEDGE, FL
    ZIP 32955
  • Facility Phone: (321) 305-5987
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL D. WILLIS
  • NPI Number: 1609252188
  • Taxonomy: 261QP3300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2082720
LAB Type Physician Office
Facility Name RIVERCOAST PAIN MANAGEMENT
Street 1899 MURRELL RD STE 130
City ROCKLEDGE
State FL
ZIP 32955
Phone 3213055987
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2024
Certificate Expiration Date 8/19/2026
Facility Type Physician Office
Lab Director MICHAEL D. WILLIS

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This page was last updated on: 5/18/2026