53D2125281 CLIA NUMBER - PAIN CARE CENTER LLC

Laboratory Demographics

  • CLIA Code: 53D2125281
  • Facility Name: PAIN CARE CENTER LLC
  • Facility Address: 329 MAIN STREET
    LANDER, WY
    ZIP 82520
  • Facility Phone: (307) 212-6270
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JED SHAY
  • NPI Number: 1023398906
  • Taxonomy: 207LP2900X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 53D2125281
LAB Type Physician Office
Facility Name PAIN CARE CENTER LLC
Street 329 MAIN STREET
City LANDER
State WY
ZIP 82520
Phone 3072126270
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2025
Certificate Expiration Date 2/2/2027
Facility Type Physician Office
Lab Director JED SHAY

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This page was last updated on: 5/18/2026