10D2131662 CLIA NUMBER - PALM BEACH PAIN, LLC

Laboratory Demographics

CLIA Number: 10D2131662

Facility Name: PALM BEACH PAIN, LLC

Facility Address:
5610 PGA BLVD STE 210
PALM BEACH GARDENS, FL
ZIP 33418
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Facility Phone Number: 561 248-1166

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1093266314

Taxonomy: 207RC0000X - Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

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
CertificateType	4
CertificateEffectiveDate	6/5/2023
CertificateExpirationDate	6/4/2025
FacilityType	Waiver

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