45D2106747 CLIA NUMBER - MODERN PAIN MANAGEMENT PLLC

Laboratory Demographics

  • CLIA Code: 45D2106747
  • Facility Name: MODERN PAIN MANAGEMENT PLLC
  • Facility Address: 902 FROSTWOOD DR SUITE 235
    HOUSTON, TX
    ZIP 77024
  • Facility Phone: 713 298-0120
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GEORGE M. ATALLAH
  • NPI Number: 1013394766
  • Taxonomy: 208VP0000X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2106747
LAB Type Physician Office
Facility Name MODERN PAIN MANAGEMENT PLLC
Street 902 FROSTWOOD DR SUITE 235
City HOUSTON
State TX
ZIP 77024
Phone 713 298-0120
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2023
Certificate Expiration Date 12/28/2025
Facility Type Physician Office
Lab Director GEORGE M. ATALLAH

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