10D2250287 CLIA NUMBER - AGAPE DETOX CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D2250287
  • Facility Name: AGAPE DETOX CENTER LLC
  • Facility Address: 750 E PRIMA VISTA BLVD
    PORT SAINT LUCIE, FL
    ZIP 34952
  • Facility Phone: 973 687-0616
  • Facility Type: Other - RESIDENTIAL SUBSTANCE ABU
  • Facility Type: Waiver
  • Lab Director: CHARLES SMITH
  • NPI Number: 1619642188
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2250287
LAB Type Other - RESIDENTIAL SUBSTANCE ABU
Facility Name AGAPE DETOX CENTER LLC
Street 750 E PRIMA VISTA BLVD
City PORT SAINT LUCIE
State FL
ZIP 34952
Phone 973 687-0616
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2024
Certificate Expiration Date 1/25/2026
Facility Type Other - RESIDENTIAL SUBSTANCE ABU
Lab Director CHARLES SMITH

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