10D2081017 CLIA NUMBER - BREAK THE CYCLE

Laboratory Demographics

  • CLIA Code: 10D2081017
  • Facility Name: BREAK THE CYCLE
  • Facility Address: 4721 E MOODY BLVD STE 107
    BUNNELL, FL
    ZIP 32110
  • Facility Phone: 386 437-0026
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: JANET G. JOHNSON
  • NPI Number: 1750708004
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2081017
LAB Type Comp. Outpatient Rehab Facility
Facility Name BREAK THE CYCLE
Street 4721 E MOODY BLVD STE 107
City BUNNELL
State FL
ZIP 32110
Phone 386 437-0026
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2024
Certificate Expiration Date 7/16/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director JANET G. JOHNSON

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