21D2042988 CLIA NUMBER - PAIN MANAGEMENT INSTITUTE

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Laboratory Demographics

CLIA Number: 21D2042988

Facility Name: PAIN MANAGEMENT INSTITUTE

Facility Address:
6410 ROCKLEDGE DRIVE STE 505
BETHESDA, MD
ZIP 20817
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Facility Phone Number: 301 530-7303

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1548470982

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	21D2042988
LAB Type	Physician Office
Facility Name	PAIN MANAGEMENT INSTITUTE
Street	6410 ROCKLEDGE DRIVE STE 505
City	BETHESDA
State	MD
ZIP	20817
Phone	301 530-7303
CertificateType	4
CertificateEffectiveDate	6/25/2022
CertificateExpirationDate	6/24/2024
FacilityType	Waiver

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