45D2044961 CLIA NUMBER - PREMIER PAIN CONSULTANTS, PA

Laboratory Demographics

  • CLIA Code: 45D2044961
  • Facility Name: PREMIER PAIN CONSULTANTS, PA
  • Facility Address: 5522 LONE STAR PARKWAY BLDG 2, STE 101
    SAN ANTONIO, TX
    ZIP 78253
  • Facility Phone: 210 616-9400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LARINA V. GUTENBERG
  • NPI Number: 1558839795
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2044961
LAB Type Physician Office
Facility Name PREMIER PAIN CONSULTANTS, PA
Street 5522 LONE STAR PARKWAY BLDG 2, STE 101
City SAN ANTONIO
State TX
ZIP 78253
Phone 210 616-9400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2024
Certificate Expiration Date 8/2/2026
Facility Type Physician Office
Lab Director LARINA V. GUTENBERG

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