21D2105461 CLIA NUMBER - CENTER FOR PAIN MANAGEMENT, LLC

Laboratory Demographics

  • CLIA Code: 21D2105461
  • Facility Name: CENTER FOR PAIN MANAGEMENT, LLC
  • Facility Address: 19735 GERMANTOWN ROAD STE 360
    GERMANTOWN, MD
    ZIP 20874
  • Facility Phone: 301 528-2810
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KRISTOFFER R. A DE LARA
  • NPI Number: 1700353307
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 21D2105461
LAB Type Physician Office
Facility Name CENTER FOR PAIN MANAGEMENT, LLC
Street 19735 GERMANTOWN ROAD STE 360
City GERMANTOWN
State MD
ZIP 20874
Phone 301 528-2810
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2023
Certificate Expiration Date 11/23/2025
Facility Type Physician Office
Lab Director KRISTOFFER R. A DE LARA

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