10D2120542 CLIA NUMBER - FLORIDA PAIN AND REHABILITATION CENTER

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Laboratory Demographics

CLIA Number: 10D2120542

Facility Name: FLORIDA PAIN AND REHABILITATION CENTER

Facility Address:
918 ROLLING ACRES RD STE 102
LADY LAKE, FL
ZIP 32159
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Facility Phone Number: 352 751-6582

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1154549905

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	10D2120542
LAB Type	Physician Office
Facility Name	FLORIDA PAIN AND REHABILITATION CENTER
Street	918 ROLLING ACRES RD STE 102
City	LADY LAKE
State	FL
ZIP	32159
Phone	352 751-6582
CertificateType	4
CertificateEffectiveDate	10/19/2022
CertificateExpirationDate	10/18/2024
FacilityType	Waiver

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