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PANACEA BRAIN AND SPINE, LLC
NPI 1154765121
Non-Pharmacy Dispensing Site in Lake Havasu City, AZ

Active since April 22, 2013CLIA 03D2048793 · Waiver
297 LAKE HAVASU AVE S, SUITE 204, LAKE HAVASU CITY, AZ 86403(928) 453-2211 Get Directions Write a Review

NPPES record last updated: April 22, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Panacea Brain And Spine, Llc NPPES

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

PANACEA BRAIN AND SPINE, LLC (NPI 1154765121) is a healthcare organization registered as a non-pharmacy dispensing site in Lake Havasu City, Arizona and active in the NPI registry since April 2013. The organization holds a CLIA Waiver certificate valid through October 22, 2026 and lists Chad E. Hartley, Owner, as its authorized official.

NPPES Registry Identity

NPI1154765121
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NamePANACEA BRAIN AND SPINE, LLC
Location Address297 LAKE HAVASU AVE S, SUITE 204Lake Havasu City, AZ 86403-6526
Mailing Address2980 N Beverly Glen Cir, Suite 301Los Angeles, CA 90077-1726 · (310) 474-9809
Phone(928) 453-2211
Organization SubpartYes
Authorized OfficialChad E. HartleyOwner · (928) 453-2211
Enumeration DateApril 22, 2013
✔ NPI 1154765121 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
297 LAKE HAVASU AVE S, Lake Havasu City, AZ 86403
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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 03D2048793

Panacea Brain And Spine LLC · Lake Havasu, AZ
Active · expires Oct 22, 2026
CLIA Number03D2048793
Laboratory TypePhysician Office
Certificate Effective DateOctober 23, 2024
Certificate Expiration DateOctober 22, 2026
Laboratory DirectorChad E. Hartley
Laboratory Phone(928) 453-2211
Laboratory LocationPanacea Brain And Spine LLC72 Lake Havasu Ave S Ste 102, Lake Havasu, AZ 86403
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

HAVASU NEUROLOGICAL CENTER PLLC
Psychiatry & Neurology (Neurology)
297 LAKE HAVASU AVE S, SUITE 106
LAKE HAVASU CITY, AZ 86403
Mohave County (928) 680-4040
E FRANKLIN LIVINGSTONE MD PC
Physical Medicine & Rehabilitation
297 LAKE HAVASU AVE S, STE 106
LAKE HAVASU CITY, AZ 86403
Mohave County (928) 854-0011
INNOVATIVE HEALTH AND WELLNESS CENTER
Registered Nurse (General Practice)
297 LAKE HAVASU AVE S, 200
LAKE HAVASU CITY, AZ 86403
Mohave County (928) 854-7666
DESERT MOUNTAIN ORTHOPAEDICS & SPORTS MEDICINE LLC
Orthopaedic Surgery
297 LAKE HAVASU AVE S, SUITE 108
LAKE HAVASU CITY, AZ 86403
Mohave County (928) 854-3333
INNOVATIVE PRIMARY CARE CLINIC OF HAVASU PLLC
Nurse Practitioner (Primary Care)
297 LAKE HAVASU AVE S, SUITE 106
LAKE HAVASU CITY, AZ 86403
Mohave County (928) 854-7666
DR. MAAME AMPOMAH DANKWAH MD, MPH
Psychiatry & Neurology (Neurology)
297 LAKE HAVASU AVE S, SUITE 106
LAKE HAVASU CITY, AZ 86403
Mohave County (928) 680-4040
INNOVATIVE WOMENS HEALTH CARE OF HAVASU PLLC
Nurse Practitioner (Women's Health)
297 LAKE HAVASU AVE S, SUITE 106
LAKE HAVASU CITY, AZ 86403
Mohave County (928) 854-7666

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 Panacea Brain And Spine, LLC's NPI number?

The NPI number for Panacea Brain And Spine, LLC is 1154765121. It was assigned to this organization in the NPPES registry on April 22, 2013.

Where is Panacea Brain And Spine, LLC located?

Panacea Brain And Spine, LLC is located at 297 Lake Havasu Ave S Suite 204, Lake Havasu City, AZ 86403. The listed phone number is (928) 453-2211.

What is Panacea Brain And Spine, LLC's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does Panacea Brain And Spine, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2048793) is associated with this NPI, valid through October 22, 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 Panacea Brain And Spine, LLC was last updated on April 22, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.