25D2041693 CLIA NUMBER - PREMIER PAIN CARE

Laboratory Demographics

  • CLIA Code: 25D2041693
  • Facility Name: PREMIER PAIN CARE
  • Facility Address: 514 F EAST WOODROW WILSON AVENUE
    JACKSON, MS
    ZIP 39216
  • Facility Phone: 601 982-3132
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LORI H. MARSHALL
  • NPI Number: 1336408186
  • Taxonomy: 261QP3300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 25D2041693
LAB Type Physician Office
Facility Name PREMIER PAIN CARE
Street 514 F EAST WOODROW WILSON AVENUE
City JACKSON
State MS
ZIP 39216
Phone 601 982-3132
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/29/2024
Certificate Expiration Date 5/28/2026
Facility Type Physician Office
Lab Director LORI H. MARSHALL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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