10D2117758 CLIA NUMBER - CENTER FOR ADDICTION & PAIN MANAGEMENT

Laboratory Demographics

CLIA Number: 10D2117758

Facility Name: CENTER FOR ADDICTION & PAIN MANAGEMENT

Facility Address:
235 CITRUS TOWER BLVD STE 104
CLERMONT, FL
ZIP 34711
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Facility Phone Number: 352 404-8160

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1295196459

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2117758
LAB Type	Physician Office
Facility Name	CENTER FOR ADDICTION & PAIN MANAGEMENT
Street	235 CITRUS TOWER BLVD STE 104
City	CLERMONT
State	FL
ZIP	34711
Phone	352 404-8160
CertificateType	4
CertificateEffectiveDate	8/23/2022
CertificateExpirationDate	8/22/2024
FacilityType	Waiver

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