10D2123378 CLIA NUMBER - REVIVAL RESEARCH CORPORATION

Laboratory Demographics

  • CLIA Code: 10D2123378
  • Facility Name: REVIVAL RESEARCH CORPORATION
  • Facility Address: 8200 NW 27TH STREET STE 116
    DORAL, FL
    ZIP 33122
  • Facility Phone: 305 505-3912
  • Facility Type: Other - MEDICAL RESEARCH
  • Facility Type: Waiver
  • Lab Director: LEYVA HANSELL
  • NPI Number: 1720598303
  • Taxonomy: 261QR1100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2123378
LAB Type Other - MEDICAL RESEARCH
Facility Name REVIVAL RESEARCH CORPORATION
Street 8200 NW 27TH STREET STE 116
City DORAL
State FL
ZIP 33122
Phone 305 505-3912
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Other - MEDICAL RESEARCH
Lab Director LEYVA HANSELL

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