10D2193800 CLIA NUMBER - KENNEDY PAIN CLINIC GROUP LLC

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Laboratory Demographics

CLIA Number: 10D2193800

Facility Name: KENNEDY PAIN CLINIC GROUP LLC

Facility Address:
5255 OFFICE PARK BLVD SUITE 107
BRADENTON, FL
ZIP 34203
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Facility Phone Number: 941 702-0066

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1821492695

Taxonomy: 171100000X - Acupuncturist
An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.

CLIA Record

Field Name	Field Value
CLIA Number	10D2193800
LAB Type	Practitioner Other
Facility Name	KENNEDY PAIN CLINIC GROUP LLC
Street	5255 OFFICE PARK BLVD SUITE 107
City	BRADENTON
State	FL
ZIP	34203
Phone	941 702-0066
CertificateType	4
CertificateEffectiveDate	9/24/2022
CertificateExpirationDate	9/23/2024
FacilityType	Waiver

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