18D2149373 CLIA NUMBER - COMMONWEALTH PAIN ASSOCIATES PLLC

Laboratory Demographics

CLIA Number: 18D2149373

Facility Name: COMMONWEALTH PAIN ASSOCIATES PLLC

Facility Address:
309 11TH STREET
CARROLLTON, KY
ZIP 41008
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Facility Phone Number: 502 916-6579

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1982184925

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	18D2149373
LAB Type	Physician Office
Facility Name	COMMONWEALTH PAIN ASSOCIATES PLLC
Street	309 11TH STREET
City	CARROLLTON
State	KY
ZIP	41008
Phone	502 916-6579
CertificateType	4
CertificateEffectiveDate	6/1/2022
CertificateExpirationDate	5/31/2024
FacilityType	Waiver

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