10D2144754 CLIA NUMBER - REPRIEVE, LLC

Laboratory Demographics

CLIA Number: 10D2144754

Facility Name: REPRIEVE, LLC

Facility Address:
4700 N CONGRESS AVE - STE 104
WEST PALM BEACH, FL
ZIP 33407
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Facility Phone Number: 848 702-5305

Facility Type: Other - SUBSTANCE ABUSE TX

Certificate Type: Waiver

NPI Number: 1528567740

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	10D2144754
LAB Type	Other - SUBSTANCE ABUSE TX
Facility Name	REPRIEVE, LLC
Street	4700 N CONGRESS AVE - STE 104
City	WEST PALM BEACH
State	FL
ZIP	33407
Phone	848 702-5305
CertificateType	4
CertificateEffectiveDate	2/22/2024
CertificateExpirationDate	2/21/2026
FacilityType	Waiver

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