10D2210223 CLIA NUMBER - PAIN, SPIN AND WELLNESS, LLC

Laboratory Demographics

  • CLIA Code: 10D2210223
  • Facility Name: PAIN, SPIN AND WELLNESS, LLC
  • Facility Address: 9770 OLD BAYMEADOWS RD STE 141
    JACKSONVILLE, FL
    ZIP 32256
  • Facility Phone: 904 944-2124
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SOURIAL MORRIS SOURIAL
  • NPI Number: 1942868377
  • Taxonomy: 207QA0505X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2210223
LAB Type Physician Office
Facility Name PAIN, SPIN AND WELLNESS, LLC
Street 9770 OLD BAYMEADOWS RD STE 141
City JACKSONVILLE
State FL
ZIP 32256
Phone 904 944-2124
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2025
Certificate Expiration Date 1/19/2027
Facility Type Physician Office
Lab Director SOURIAL MORRIS SOURIAL

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