10D2255142 CLIA NUMBER - PROACTIVE HEALTH RX

Laboratory Demographics

  • CLIA Code: 10D2255142
  • Facility Name: PROACTIVE HEALTH RX
  • Facility Address: 3309 NORTHLAKE BLVD SUITE 101
    PALM BEACH GARDENS, FL
    ZIP 33403
  • Facility Phone: 561 621-3051
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CRYSTAL L. CROSSLEY
  • NPI Number: 1730835018
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2255142
LAB Type Physician Office
Facility Name PROACTIVE HEALTH RX
Street 3309 NORTHLAKE BLVD SUITE 101
City PALM BEACH GARDENS
State FL
ZIP 33403
Phone 561 621-3051
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Physician Office
Lab Director CRYSTAL L. CROSSLEY

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