10D2113522 CLIA NUMBER - FOUNDATIONS WELLNESS CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D2113522
  • Facility Name: FOUNDATIONS WELLNESS CENTER LLC
  • Facility Address: 160 NW CENTRAL PARK PLAZA STE 110
    PORT SAINT LUCIE, FL
    ZIP 34986
  • Facility Phone: 772 212-9858
  • Facility Type: Other - OUTPATIENT SUD TREATMENT
  • Facility Type: Waiver
  • Lab Director: LISA M. FLYNN
  • NPI Number: 1194188656
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2113522
LAB Type Other - OUTPATIENT SUD TREATMENT
Facility Name FOUNDATIONS WELLNESS CENTER LLC
Street 160 NW CENTRAL PARK PLAZA STE 110
City PORT SAINT LUCIE
State FL
ZIP 34986
Phone 772 212-9858
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Other - OUTPATIENT SUD TREATMENT
Lab Director LISA M. FLYNN

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