11D2071918 CLIA NUMBER - GEORGIA PAIN AND WELLNESS CENTER

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Laboratory Demographics

CLIA Number: 11D2071918

Facility Name: GEORGIA PAIN AND WELLNESS CENTER

Facility Address:
1200 BALD RIDGE MARINA ROAD, SUITE 150
CUMMING, GA
ZIP 30041
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Facility Phone Number: 770 962-3642

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1538671847

Taxonomy: 208VP0014X - Pain Medicine
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

CLIA Record

Field Name	Field Value
CLIA Number	11D2071918
LAB Type	Physician Office
Facility Name	GEORGIA PAIN AND WELLNESS CENTER
Street	1200 BALD RIDGE MARINA ROAD, SUITE 150
City	CUMMING
State	GA
ZIP	30041
Phone	770 962-3642
CertificateType	1
CertificateEffectiveDate	11/16/2022
CertificateExpirationDate	11/15/2024
FacilityType	Accreditation

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