34D2085408 CLIA NUMBER - INTERVENTIONAL PAIN CENTER PLLC

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Laboratory Demographics

CLIA Number: 34D2085408

Facility Name: INTERVENTIONAL PAIN CENTER PLLC

Facility Address:
4320 FAYETTEVILLE ROAD, SUITE A
LUMBERTON, NC
ZIP 28358
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Facility Phone Number: 910 738-9599

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1790220408

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	34D2085408
LAB Type	Physician Office
Facility Name	INTERVENTIONAL PAIN CENTER PLLC
Street	4320 FAYETTEVILLE ROAD, SUITE A
City	LUMBERTON
State	NC
ZIP	28358
Phone	910 738-9599
CertificateType	4
CertificateEffectiveDate	10/14/2022
CertificateExpirationDate	10/13/2024
FacilityType	Waiver

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