45D2203718 CLIA NUMBER - CENTRAL TEXAS PAIN CENTER

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Laboratory Demographics

CLIA Number: 45D2203718

Facility Name: CENTRAL TEXAS PAIN CENTER

Facility Address:
1304 WONDERWORLD
SAN MARCOS, TX
ZIP 78666
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Facility Phone Number: 512 953-8121

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1154823201

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	45D2203718
LAB Type	Physician Office
Facility Name	CENTRAL TEXAS PAIN CENTER
Street	1304 WONDERWORLD
City	SAN MARCOS
State	TX
ZIP	78666
Phone	512 953-8121
CertificateType	4
CertificateEffectiveDate	12/4/2022
CertificateExpirationDate	12/3/2024
FacilityType	Waiver

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