44D2057204 CLIA NUMBER - INTERVENTIONAL PAIN CENTER, PLLC

Laboratory Demographics

  • CLIA Code: 44D2057204
  • Facility Name: INTERVENTIONAL PAIN CENTER, PLLC
  • Facility Address: 353 NEW SHACKLE ISLAND RD, STE 148-C
    HENDERSONVILLE, TN
    ZIP 37075
  • Facility Phone: 615 972-1100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. BRAD P. WILSON
  • NPI Number: 1285976407
  • Taxonomy: 2081P2900X - Physical Medicine & Rehabilitation

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CLIA Record

Field Name Field Value
CLIA Number 44D2057204
LAB Type Physician Office
Facility Name INTERVENTIONAL PAIN CENTER, PLLC
Street 353 NEW SHACKLE ISLAND RD, STE 148-C
City HENDERSONVILLE
State TN
ZIP 37075
Phone 615 972-1100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2025
Certificate Expiration Date 4/10/2027
Facility Type Physician Office
Lab Director DR. BRAD P. WILSON

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