26D2001523 CLIA NUMBER - INTERVENTIONAL PAIN CENTER OF CHESTERFIELD

Laboratory Demographics

  • CLIA Code: 26D2001523
  • Facility Name: INTERVENTIONAL PAIN CENTER OF CHESTERFIELD
  • Facility Address: 17300 N OUTER 40 RD STE 100
    CHESTERFIELD, MO
    ZIP 63005
  • Facility Phone: 636 728-1977
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RAMIS GHEITH
  • NPI Number: 1922144484
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D2001523
LAB Type Ambulatory Surgery Center
Facility Name INTERVENTIONAL PAIN CENTER OF CHESTERFIELD
Street 17300 N OUTER 40 RD STE 100
City CHESTERFIELD
State MO
ZIP 63005
Phone 636 728-1977
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2023
Certificate Expiration Date 12/21/2025
Facility Type Ambulatory Surgery Center
Lab Director RAMIS GHEITH

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This page was last updated on: 6/4/2025