45D2164445 CLIA NUMBER - MODERN PAIN MANAGEMENT, PLLC

Laboratory Demographics

  • CLIA Code: 45D2164445
  • Facility Name: MODERN PAIN MANAGEMENT, PLLC
  • Facility Address: 12930 DAIRY ASHFORD DRIVE UNIT 501
    SUGAR LAND, TX
    ZIP 77478
  • Facility Phone: 713 298-0120
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GEORGE M. ATALLAH
  • NPI Number: 1952993560
  • Taxonomy: 208VP0000X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2164445
LAB Type Physician Office
Facility Name MODERN PAIN MANAGEMENT, PLLC
Street 12930 DAIRY ASHFORD DRIVE UNIT 501
City SUGAR LAND
State TX
ZIP 77478
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 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Physician Office
Lab Director GEORGE M. ATALLAH

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