42D2134448 CLIA NUMBER - CAROLINA INTERVENTIONAL PAIN INSTITUTE, LLC

Laboratory Demographics

CLIA Code: 42D2134448
Facility Name: CAROLINA INTERVENTIONAL PAIN INSTITUTE, LLC
Facility Address: 2611 FOREST DRIVE, SUITE 100
COLUMBIA, SC
ZIP 29204
Facility Phone: 803 779-3263
Facility Type: Ambulatory Surgery Center
Facility Type: Waiver
Lab Director: EZRA A. RIBER
NPI Number: 1912173733
Taxonomy: 322D00000X - Residential Treatment Facility, Emotionally Disturbed Children

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CLIA Record

Field Name	Field Value
CLIA Number	42D2134448
LAB Type	Ambulatory Surgery Center
Facility Name	CAROLINA INTERVENTIONAL PAIN INSTITUTE, LLC
Street	2611 FOREST DRIVE, SUITE 100
City	COLUMBIA
State	SC
ZIP	29204
Phone	803 779-3263
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	8/2/2025
Certificate Expiration Date	8/1/2027
Facility Type	Ambulatory Surgery Center
Lab Director	EZRA A. RIBER

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