10D1027487 CLIA NUMBER - REVA INC

Laboratory Demographics

CLIA Number: 10D1027487

Facility Name: REVA INC

Facility Address:
1745 NW 51ST PL HANGER 73
FORT LAUDERDALE, FL
ZIP 33309
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Facility Phone Number: 954 730-9300

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1568580926

Taxonomy: 3416A0800X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	10D1027487
LAB Type	Other
Facility Name	REVA INC
Street	1745 NW 51ST PL HANGER 73
City	FORT LAUDERDALE
State	FL
ZIP	33309
Phone	954 730-9300
CertificateType	4
CertificateEffectiveDate	7/1/2022
CertificateExpirationDate	6/30/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024