11D2271833 CLIA NUMBER - OPTIMUM PAIN MANAGEMENT CENTER LLC

Laboratory Demographics

  • CLIA Code: 11D2271833
  • Facility Name: OPTIMUM PAIN MANAGEMENT CENTER LLC
  • Facility Address: 4775 JIMMY CARTER BOULEVARD #102
    NORCROSS, GA
    ZIP 30093
  • Facility Phone: (678) 451-1828
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEVEN T. NGUYEN
  • NPI Number: 1306583141
  • Taxonomy: 207LP2900X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 11D2271833
LAB Type Physician Office
Facility Name OPTIMUM PAIN MANAGEMENT CENTER LLC
Street 4775 JIMMY CARTER BOULEVARD #102
City NORCROSS
State GA
ZIP 30093
Phone 6784511828
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Physician Office
Lab Director STEVEN T. NGUYEN

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This page was last updated on: 5/15/2026