45D2107659 CLIA NUMBER - INTERVENTIONAL PAIN SPECIALISTS, PLLC DBA PRINCIPLE SPINE AND PAIN

Laboratory Demographics

  • CLIA Code: 45D2107659
  • Facility Name: INTERVENTIONAL PAIN SPECIALISTS, PLLC DBA PRINCIPLE SPINE AND PAIN
  • Facility Address: 16840 BUCCANEER LANE, SUITE 202
    HOUSTON, TX
    ZIP 77058
  • Facility Phone: 281 991-2200
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. DICKSON O. BISONG
  • NPI Number: 1144722380
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2107659
LAB Type Physician Office
Facility Name INTERVENTIONAL PAIN SPECIALISTS, PLLC DBA PRINCIPLE SPINE AND PAIN
Street 16840 BUCCANEER LANE, SUITE 202
City HOUSTON
State TX
ZIP 77058
Phone 281 991-2200
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type Physician Office
Lab Director DR. DICKSON O. BISONG

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