31D2087578 CLIA NUMBER - SPINE AND PAIN SPECIALITY CARE

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Laboratory Demographics

CLIA Number: 31D2087578

Facility Name: SPINE AND PAIN SPECIALITY CARE

Facility Address:
219 S BROAD STREET
ELIZABETH, NJ
ZIP 07202
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Facility Phone Number: 201 877-0518

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1881090413

Taxonomy: 207LP2900X - Anesthesiology
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.

CLIA Record

Field Name	Field Value
CLIA Number	31D2087578
LAB Type	Physician Office
Facility Name	SPINE AND PAIN SPECIALITY CARE
Street	219 S BROAD STREET
City	ELIZABETH
State	NJ
ZIP	07202
Phone	201 877-0518
CertificateType	4
CertificateEffectiveDate	12/1/2022
CertificateExpirationDate	11/30/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024