42D2104777 CLIA NUMBER - PAUL MITCHELL PAIN MANAGEMENT

Laboratory Demographics

  • CLIA Code: 42D2104777
  • Facility Name: PAUL MITCHELL PAIN MANAGEMENT
  • Facility Address: 15 MOSS CREEK VILLAGE
    HILTON HEAD ISLAND, SC
    ZIP 29926
  • Facility Phone: 843 415-8511
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAUL R. MITCHELL
  • NPI Number: 1699728477
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 42D2104777
LAB Type Physician Office
Facility Name PAUL MITCHELL PAIN MANAGEMENT
Street 15 MOSS CREEK VILLAGE
City HILTON HEAD ISLAND
State SC
ZIP 29926
Phone 843 415-8511
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2023
Certificate Expiration Date 11/11/2025
Facility Type Physician Office
Lab Director PAUL R. MITCHELL

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This page was last updated on: 3/20/2025