33D2188910 CLIA NUMBER - TRI STAR PHYSICIAN LLC COMMUNITY PAIN MEDICINE

Laboratory Demographics

CLIA Number: 33D2188910

Facility Name: TRI STAR PHYSICIAN LLC COMMUNITY PAIN MEDICINE

Facility Address:
14021 32ND AVE STE C1
FLUSHING, NY
ZIP 11354
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Facility Phone Number: 718 224-1600

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1144519042

Taxonomy: 208VP0014X - Pain Medicine
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

CLIA Record

Field Name	Field Value
CLIA Number	33D2188910
LAB Type	Physician Office
Facility Name	TRI STAR PHYSICIAN LLC COMMUNITY PAIN MEDICINE
Street	14021 32ND AVE STE C1
City	FLUSHING
State	NY
ZIP	11354
Phone	718 224-1600
CertificateType	4
CertificateEffectiveDate	7/23/2022
CertificateExpirationDate	7/22/2024
FacilityType	Waiver

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