PRO PAIN
NPI 1689947202
Clinic/Center - Pain in Fenton, MO
- Organization
- Clinic/Center
- Pain
- CLIA Number: 26D2015380
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-25-2026
About PRO PAIN
This page provides the complete NPI Profile along with additional information for Pro Pain, a provider established in Fenton, Missouri operating as a Clinic/center, focusing in pain . The healthcare provider is registered in the NPI registry with number 1689947202 assigned on February 2012. The practitioner's primary taxonomy code is 261QP3300X. The provider is registered as an organization and their NPI record was last updated 14 years ago. The provider's is doing business as Pro Pain. The authorized official of this NPI record is Donna L Rau (Office Manager)
- NPI
- 1689947202 Verify this NPI
- Provider Legal Name
- SOUTH COUNTY ANESTHESIA ASSOCIATES, LTD
- Other Organization Name
- PRO PAIN
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1055 BOWLES AVE SUITE 200 FENTON, MO 63026
- Location Phone
- (636) 496-3900
- Location Fax
- (636) 386-1170
- Mailing Address
- PO BOX 22407 SAINT LOUIS, MO 63126
- Mailing Phone
- (636) 386-7222
- Mailing Fax
- (636) 386-1170
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 02-13-2012
- Last Update Date
- 01-08-2013
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Pain
- Taxonomy Code
- 261QP3300X
- Type
- Ambulatory Health Care Facilities
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 26D2015380
- Facility Type
- Physician Office
- Certificate Effective Date
- October 26, 2024
- Certificate Expiration Date
- October 25, 2026
- Laboratory Director
- MICHAEL BOEDEFELD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Pro Pain to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
FENTON, MO 63026
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1689947202, enumerated as an "organization" on February 13, 2012.
The provider is located at 1055 BOWLES AVE SUITE 200 FENTON, MO 63026 and the phone number is (636) 496-3900.
Clinic/Center with taxonomy code 261QP3300X and a focus in Pain.
