36D1082567 CLIA NUMBER - PAIN MANAGEMENT INSTITUTE

Laboratory Demographics

  • CLIA Code: 36D1082567
  • Facility Name: PAIN MANAGEMENT INSTITUTE
  • Facility Address: 1761 BEALL AVENUE SUITE A
    WOOSTER, OH
    ZIP 44691
  • Facility Phone: 330 202-5580
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: A HARRIS BASALI MD
  • NPI Number: 1992972111
  • Taxonomy: 261QP3300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D1082567
LAB Type Physician Office
Facility Name PAIN MANAGEMENT INSTITUTE
Street 1761 BEALL AVENUE SUITE A
City WOOSTER
State OH
ZIP 44691
Phone 330 202-5580
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2024
Certificate Expiration Date 4/13/2026
Facility Type Physician Office
Lab Director A HARRIS BASALI MD

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