14D1030530 CLIA NUMBER - PAIN MANAGEMENT CENTERS OF AMERICA

Laboratory Demographics

CLIA Number: 14D1030530

Facility Name: PAIN MANAGEMENT CENTERS OF AMERICA

Facility Address:
108 AIRWAY DRIVE
MARION, IL
ZIP 62959
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Facility Phone Number: 618 997-7820

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1891267688

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	14D1030530
LAB Type	Physician Office
Facility Name	PAIN MANAGEMENT CENTERS OF AMERICA
Street	108 AIRWAY DRIVE
City	MARION
State	IL
ZIP	62959
Phone	618 997-7820
CertificateType	4
CertificateEffectiveDate	9/8/2022
CertificateExpirationDate	9/7/2024
FacilityType	Waiver

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