10D2141810 CLIA NUMBER - REJUVEUNIQUE, INC

Laboratory Demographics

CLIA Number: 10D2141810

Facility Name: REJUVEUNIQUE, INC

Facility Address:
4259 10TH AVENUE NORTH
PALM SPRINGS, FL
ZIP 33461
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Facility Phone Number: 239 226-0910

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1962917153

Taxonomy: 261QP3300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2141810
LAB Type	Physician Office
Facility Name	REJUVEUNIQUE, INC
Street	4259 10TH AVENUE NORTH
City	PALM SPRINGS
State	FL
ZIP	33461
Phone	239 226-0910
CertificateType	4
CertificateEffectiveDate	12/21/2023
CertificateExpirationDate	12/20/2025
FacilityType	Waiver

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