10D2097628 CLIA NUMBER - ST JUDE PAIN AND REHABILITATION SPECIALISTS

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Laboratory Demographics

CLIA Number: 10D2097628

Facility Name: ST JUDE PAIN AND REHABILITATION SPECIALISTS

Facility Address:
2828 SOUTH SEACREST BLVD STE 211
BOYNTON BEACH, FL
ZIP 33435
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Facility Phone Number: 561 369-7644

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1184011496

Taxonomy: 208VP0014X - Pain Medicine
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

CLIA Record

Field Name	Field Value
CLIA Number	10D2097628
LAB Type	Physician Office
Facility Name	ST JUDE PAIN AND REHABILITATION SPECIALISTS
Street	2828 SOUTH SEACREST BLVD STE 211
City	BOYNTON BEACH
State	FL
ZIP	33435
Phone	561 369-7644
CertificateType	4
CertificateEffectiveDate	6/19/2023
CertificateExpirationDate	6/18/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024