36D2066144 CLIA NUMBER - SPINE LLC

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Laboratory Demographics

CLIA Number: 36D2066144

Facility Name: SPINE LLC

Facility Address:
1090 BEECHER XING N SUITE A
GAHANNA, OH
ZIP 43230
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Facility Phone Number: 614 392-5336

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1780987768

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	36D2066144
LAB Type	Practitioner Other
Facility Name	SPINE LLC
Street	1090 BEECHER XING N SUITE A
City	GAHANNA
State	OH
ZIP	43230
Phone	614 392-5336
CertificateType	4
CertificateEffectiveDate	9/23/2023
CertificateExpirationDate	9/22/2025
FacilityType	Waiver

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