34D2259976 CLIA NUMBER - PAVANA TREATMENT GROUP, PC

Laboratory Demographics

  • CLIA Code: 34D2259976
  • Facility Name: PAVANA TREATMENT GROUP, PC
  • Facility Address: 1309 E SUNSET DR
    MONROE, NC
    ZIP 28112
  • Facility Phone: 704 490-4993
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT G. ELLIS
  • NPI Number: 1043849896
  • Taxonomy: 207LA0401X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 34D2259976
LAB Type Physician Office
Facility Name PAVANA TREATMENT GROUP, PC
Street 1309 E SUNSET DR
City MONROE
State NC
ZIP 28112
Phone 704 490-4993
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2024
Certificate Expiration Date 5/12/2026
Facility Type Physician Office
Lab Director ROBERT G. ELLIS

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