13D2016348 CLIA NUMBER - IDAHO PAIN CLINIC

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Laboratory Demographics

CLIA Number: 13D2016348

Facility Name: IDAHO PAIN CLINIC

Facility Address:
1327 SUPERIOR ST #101
SANDPOINT, ID
ZIP 83864
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Facility Phone Number: 208 263-9757

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1417267329

Taxonomy: 207LP2900X - Anesthesiology
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

CLIA Record

Field Name	Field Value
CLIA Number	13D2016348
LAB Type	Physician Office
Facility Name	IDAHO PAIN CLINIC
Street	1327 SUPERIOR ST #101
City	SANDPOINT
State	ID
ZIP	83864
Phone	208 263-9757
CertificateType	2
CertificateEffectiveDate	8/20/2022
CertificateExpirationDate	8/19/2024
FacilityType	Compliance

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