10D2160302 CLIA NUMBER - SUN COAST RECOVERY RANCH LLC

Laboratory Demographics

  • CLIA Code: 10D2160302
  • Facility Name: SUN COAST RECOVERY RANCH LLC
  • Facility Address: 4801 HANCOCK ROAD
    SOUTHWEST RANCHES, FL
    ZIP 33330
  • Facility Phone: 954 200-2053
  • Facility Type: Other - FREESTANDING OP FACILITY
  • Facility Type: Waiver
  • Lab Director: SALVATORE PACE
  • NPI Number: 1841664539
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2160302
LAB Type Other - FREESTANDING OP FACILITY
Facility Name SUN COAST RECOVERY RANCH LLC
Street 4801 HANCOCK ROAD
City SOUTHWEST RANCHES
State FL
ZIP 33330
Phone 954 200-2053
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2025
Certificate Expiration Date 1/7/2027
Facility Type Other - FREESTANDING OP FACILITY
Lab Director SALVATORE PACE

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