25D2097351 CLIA NUMBER - PHYSICIANS PAIN AND SPINE SPECIALISTS

Laboratory Demographics

  • CLIA Code: 25D2097351
  • Facility Name: PHYSICIANS PAIN AND SPINE SPECIALISTS
  • Facility Address: 14986 ANGELA DRIVE
    GULFPORT, MS
    ZIP 39503
  • Facility Phone: 000 228-3575
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MAJA WU
  • NPI Number: 1639417819
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D2097351
LAB Type Physician Office
Facility Name PHYSICIANS PAIN AND SPINE SPECIALISTS
Street 14986 ANGELA DRIVE
City GULFPORT
State MS
ZIP 39503
Phone 000 228-3575
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2025
Certificate Expiration Date 6/14/2027
Facility Type Physician Office
Lab Director MAJA WU

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