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LAKE STREET PAIN RELIEF CENTER, INC
NPI 1104043355
Chiropractor in Minneapolis, MN

Active since April 19, 2007CLIA 24D2312122 · Waiver
515 W LAKE ST STE F, MINNEAPOLIS, MN 55408(612) 827-7246(612) 827-8206 Get Directions Write a Review

NPPES record last updated: March 16, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 16, 2020, Jul 25, 2018 (2 updates tracked since 2018).

About Lake Street Pain Relief Center, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE STREET PAIN RELIEF CENTER, INC (NPI 1104043355) is a healthcare organization registered as a chiropractor in Minneapolis, Minnesota and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through October 3, 2026 and lists Arelis Garcia, Medical Billing Supervisor, as its authorized official.

NPPES Registry Identity

NPI1104043355
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameLAKE STREET PAIN RELIEF CENTER, INC
Location Address515 W LAKE ST STE FMinneapolis, MN 55408-2981
Mailing Address1304 E Lake St Ste 101Minneapolis, MN 55407-1777 · (612) 827-7246 · Fax (612) 827-8206
Phone(612) 827-7246
Fax(612) 827-8206
Organization SubpartNo
Authorized OfficialArelis GarciaMedical Billing Supervisor · (954) 990-8134
Enumeration DateApril 19, 2007
Last NPPES UpdateMarch 16, 20202 updates tracked since enumeration
NPPES CertifiedMarch 16, 2020
✔ NPI 1104043355 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
515 W LAKE ST STE F, Minneapolis, MN 55408
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2312122

Lake Street Pain Relief Center · Minneapolis, MN
Active · expires Oct 3, 2026
CLIA Number24D2312122
Laboratory TypePhysician Office
Certificate Effective DateOctober 4, 2024
Certificate Expiration DateOctober 3, 2026
Laboratory DirectorBradley Bengston
Laboratory Phone(612) 827-7246
Laboratory LocationLake Street Pain Relief Center515 W Lake St , Suite F, Minneapolis, MN 55408
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUHUR AHMED
Massage Therapist
515 W LAKE ST STE F
MINNEAPOLIS, MN 55408
Hennepin County (612) 823-3409
LS PAIN RELIEF CENTER PA
Chiropractor
515 W LAKE ST STE F
MINNEAPOLIS, MN 55408
Hennepin County (612) 827-7246
PRIME MEDICAL CENTERS LLC
General Practice
515 W LAKE ST STE F
MINNEAPOLIS, MN 55408
Hennepin County (612) 930-4848

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Street Pain Relief Center, Inc's NPI number?

The NPI number for Lake Street Pain Relief Center, Inc is 1104043355. It was assigned to this organization in the NPPES registry on April 19, 2007.

Where is Lake Street Pain Relief Center, Inc located?

Lake Street Pain Relief Center, Inc is located at 515 W Lake St Ste F, Minneapolis, MN 55408. The listed phone number is (612) 827-7246.

What is Lake Street Pain Relief Center, Inc's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Does Lake Street Pain Relief Center, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2312122) is associated with this NPI, valid through October 3, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lake Street Pain Relief Center, Inc was last updated on March 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.