10D2131662 CLIA NUMBER - PALM BEACH PAIN, LLC

Laboratory Demographics

  • CLIA Code: 10D2131662
  • Facility Name: PALM BEACH PAIN, LLC
  • Facility Address: 5610 PGA BLVD STE 210
    PALM BEACH GARDENS, FL
    ZIP 33418
  • Facility Phone: 561 248-1166
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICARDO A. LEANO
  • NPI Number: 1093266314
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2131662
LAB Type Physician Office
Facility Name PALM BEACH PAIN, LLC
Street 5610 PGA BLVD STE 210
City PALM BEACH GARDENS
State FL
ZIP 33418
Phone 561 248-1166
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2023
Certificate Expiration Date 6/4/2025
Facility Type Physician Office
Lab Director RICARDO A. LEANO

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This page was last updated on: 3/20/2025