34D2083367 CLIA NUMBER - INTERVENTIONAL PAIN CENTER PLLC

Laboratory Demographics

  • CLIA Code: 34D2083367
  • Facility Name: INTERVENTIONAL PAIN CENTER PLLC
  • Facility Address: 517 NC-210, SUITE B
    SPRING LAKE, NC
    ZIP 28390
  • Facility Phone: 910 436-0777
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOUGLAS WISOR
  • NPI Number: 1205372588
  • Taxonomy: 207LP2900X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 34D2083367
LAB Type Physician Office
Facility Name INTERVENTIONAL PAIN CENTER PLLC
Street 517 NC-210, SUITE B
City SPRING LAKE
State NC
ZIP 28390
Phone 910 436-0777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/4/2024
Certificate Expiration Date 9/3/2026
Facility Type Physician Office
Lab Director DOUGLAS WISOR

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