10D2174301 CLIA NUMBER - CELADON RECOVERY

Laboratory Demographics

  • CLIA Code: 10D2174301
  • Facility Name: CELADON RECOVERY
  • Facility Address: 3331 EAST RIVERSIDE DR
    FORT MYERS, FL
    ZIP 33916
  • Facility Phone: 719 820-1078
  • Facility Type: Other - RESIDENTIAL THERAPEUTIC C
  • Facility Type: Waiver
  • Lab Director: MICHELLE GRAY
  • NPI Number: 1649813858
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2174301
LAB Type Other - RESIDENTIAL THERAPEUTIC C
Facility Name CELADON RECOVERY
Street 3331 EAST RIVERSIDE DR
City FORT MYERS
State FL
ZIP 33916
Phone 719 820-1078
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2023
Certificate Expiration Date 10/28/2025
Facility Type Other - RESIDENTIAL THERAPEUTIC C
Lab Director MICHELLE GRAY

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