34D2236419 CLIA NUMBER - MITRA PAIN MANAGEMENT PLLC

Laboratory Demographics

CLIA Number: 34D2236419

Facility Name: MITRA PAIN MANAGEMENT PLLC

Facility Address:
605 ATTAIN ST SUITE 121
FUQUAY VARINA, NC
ZIP 27526
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Facility Phone Number: 919 525-1501

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1538731294

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	34D2236419
LAB Type	Physician Office
Facility Name	MITRA PAIN MANAGEMENT PLLC
Street	605 ATTAIN ST SUITE 121
City	FUQUAY VARINA
State	NC
ZIP	27526
Phone	919 525-1501
CertificateType	4
CertificateEffectiveDate	9/16/2023
CertificateExpirationDate	9/15/2025
FacilityType	Waiver

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