52D2090719 CLIA NUMBER - INTEGRATIVE PAIN MANAGEMENT

Laboratory Demographics

  • CLIA Code: 52D2090719
  • Facility Name: INTEGRATIVE PAIN MANAGEMENT
  • Facility Address: 3108 MID VALLEY RD
    DE PERE, WI
    ZIP 54115
  • Facility Phone: 920 532-9117
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JOHN JOSEPH
  • NPI Number: 1487246427
  • Taxonomy: 207L00000X - Anesthesiology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 52D2090719
LAB Type Physician Office
Facility Name INTEGRATIVE PAIN MANAGEMENT
Street 3108 MID VALLEY RD
City DE PERE
State WI
ZIP 54115
Phone 920 532-9117
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/29/2025
Certificate Expiration Date 1/28/2027
Facility Type Physician Office
Lab Director DR. JOHN JOSEPH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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