21D2165391 CLIA NUMBER - IDEAL PAIN MANAGEMENT LLC

Laboratory Demographics

  • CLIA Code: 21D2165391
  • Facility Name: IDEAL PAIN MANAGEMENT LLC
  • Facility Address: 7505 OSLER DR STE 204
    TOWSON, MD
    ZIP 21204
  • Facility Phone: 443 519-5353
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MONISH B. GARIWALA
  • NPI Number: 1154802874
  • Taxonomy: 261QP3300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2165391
LAB Type Physician Office
Facility Name IDEAL PAIN MANAGEMENT LLC
Street 7505 OSLER DR STE 204
City TOWSON
State MD
ZIP 21204
Phone 443 519-5353
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Physician Office
Lab Director MONISH B. GARIWALA

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