53D2253172 CLIA NUMBER - PAIN CARE CENTER LLC

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CLIA Record

Field Name Field Value
CLIA Number 53D2253172
LAB Type Physician Office
Facility Name PAIN CARE CENTER LLC
Street 945 WEST BROADWAY, STE 202
City JACKSON
State WY
ZIP 83001
Phone 307 212-6270
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2024
Certificate Expiration Date 2/16/2026
Facility Type Physician Office
Lab Director JED SHAY

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