18D2275378 CLIA NUMBER - CLARK REGIONAL INTERVENTIONAL PAIN MANAGEMENT

Laboratory Demographics

  • CLIA Code: 18D2275378
  • Facility Name: CLARK REGIONAL INTERVENTIONAL PAIN MANAGEMENT
  • Facility Address: 128 STONE TRACE
    MOUNT STERLING, KY
    ZIP 40353
  • Facility Phone: 859 737-6559
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ANAND MODADUGU
  • NPI Number: 1780356253
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 18D2275378
LAB Type Physician Office
Facility Name CLARK REGIONAL INTERVENTIONAL PAIN MANAGEMENT
Street 128 STONE TRACE
City MOUNT STERLING
State KY
ZIP 40353
Phone 859 737-6559
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2025
Certificate Expiration Date 1/19/2027
Facility Type Physician Office
Lab Director DR. ANAND MODADUGU

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This page was last updated on: 9/29/2025