18D2189554 CLIA NUMBER - ELITE PAIN AND SPINE

Laboratory Demographics

CLIA Number: 18D2189554

Facility Name: ELITE PAIN AND SPINE

Facility Address:
4645 VILLAGE SQUARE DR, SUITE C
PADUCAH, KY
ZIP 42001
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Facility Phone Number: 270 228-0118

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1295377497

Taxonomy: 2081P2900X - Physical Medicine & Rehabilitation
A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.

CLIA Record

Field Name	Field Value
CLIA Number	18D2189554
LAB Type	Physician Office
Facility Name	ELITE PAIN AND SPINE
Street	4645 VILLAGE SQUARE DR, SUITE C
City	PADUCAH
State	KY
ZIP	42001
Phone	270 228-0118
CertificateType	1
CertificateEffectiveDate	1/16/2024
CertificateExpirationDate	1/15/2026
FacilityType	Accreditation

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