25D1005524 CLIA NUMBER - PAIN TREATMENT CENTER, LLC

Laboratory Demographics

  • CLIA Code: 25D1005524
  • Facility Name: PAIN TREATMENT CENTER, LLC
  • Facility Address: 106 ASBURY CIRCLE
    HATTIESBURG, MS
    ZIP 39402
  • Facility Phone: 601 261-6737
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DAVID L. MCKELLAR
  • NPI Number: 1174689533
  • Taxonomy: 261QP3300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D1005524
LAB Type Ambulatory Surgery Center
Facility Name PAIN TREATMENT CENTER, LLC
Street 106 ASBURY CIRCLE
City HATTIESBURG
State MS
ZIP 39402
Phone 601 261-6737
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2024
Certificate Expiration Date 10/23/2026
Facility Type Ambulatory Surgery Center
Lab Director DAVID L. MCKELLAR

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