21D2142057 CLIA NUMBER - PROACTIVE PAIN AND NEUROLOGY, LLC

Laboratory Demographics

  • CLIA Code: 21D2142057
  • Facility Name: PROACTIVE PAIN AND NEUROLOGY, LLC
  • Facility Address: 921 SETON DRIVE SUITE F & G
    CUMBERLAND, MD
    ZIP 21502
  • Facility Phone: 240 522-0098
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DENNIS D. DEY MD
  • NPI Number: 1417460619
  • Taxonomy: 2084N0400X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 21D2142057
LAB Type Physician Office
Facility Name PROACTIVE PAIN AND NEUROLOGY, LLC
Street 921 SETON DRIVE SUITE F & G
City CUMBERLAND
State MD
ZIP 21502
Phone 240 522-0098
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type Physician Office
Lab Director DENNIS D. DEY MD

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