10D2166032 CLIA NUMBER - PRO ACTIVE PAIN CARE, P.A.

Laboratory Demographics

  • CLIA Code: 10D2166032
  • Facility Name: PRO ACTIVE PAIN CARE, P.A.
  • Facility Address: 27160 BAY LANDING DR UNIT 200
    BONITA SPRINGS, FL
    ZIP 34135
  • Facility Phone: 239 676-5665
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL MARTINEZ
  • NPI Number: 1710457106
  • Taxonomy: 207LP2900X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 10D2166032
LAB Type Physician Office
Facility Name PRO ACTIVE PAIN CARE, P.A.
Street 27160 BAY LANDING DR UNIT 200
City BONITA SPRINGS
State FL
ZIP 34135
Phone 239 676-5665
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2025
Certificate Expiration Date 5/9/2027
Facility Type Physician Office
Lab Director MICHAEL MARTINEZ

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This page was last updated on: 9/29/2025