44D2063122 CLIA NUMBER - SPINE AND PAIN PHYSICIANS SURGERY CENTER

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Laboratory Demographics

CLIA Number: 44D2063122

Facility Name: SPINE AND PAIN PHYSICIANS SURGERY CENTER

Facility Address:
1177 ROCK SPRINGS RD SUITE 130
SMYRNA, TN
ZIP 37167
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Facility Phone Number: 615 459-3881

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1770837866

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	44D2063122
LAB Type	Ambulatory Surgery Center
Facility Name	SPINE AND PAIN PHYSICIANS SURGERY CENTER
Street	1177 ROCK SPRINGS RD SUITE 130
City	SMYRNA
State	TN
ZIP	37167
Phone	615 459-3881
CertificateType	4
CertificateEffectiveDate	7/26/2023
CertificateExpirationDate	7/25/2025
FacilityType	Waiver

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