34D2091767 CLIA NUMBER - INTERVENTIONAL PAIN CENTER, PLLC

Laboratory Demographics

  • CLIA Code: 34D2091767
  • Facility Name: INTERVENTIONAL PAIN CENTER, PLLC
  • Facility Address: 2080 W ARLINGTON BLVD, SUITE A
    GREENVILLE, NC
    ZIP 27834
  • Facility Phone: 252 689-6161
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOUGLAS WISOR
  • NPI Number: 1912443821
  • Taxonomy: 207LP2900X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 34D2091767
LAB Type Physician Office
Facility Name INTERVENTIONAL PAIN CENTER, PLLC
Street 2080 W ARLINGTON BLVD, SUITE A
City GREENVILLE
State NC
ZIP 27834
Phone 252 689-6161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/19/2025
Certificate Expiration Date 2/18/2027
Facility Type Physician Office
Lab Director DOUGLAS WISOR

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This page was last updated on: 9/29/2025