10D2300231 CLIA NUMBER - RADIANT RECHARGE LLC

Laboratory Demographics

  • CLIA Code: 10D2300231
  • Facility Name: RADIANT RECHARGE LLC
  • Facility Address: 466 SW PORT ST LUCIE BLVD SUITE 114
    PORT SAINT LUCIE, FL
    ZIP 34953
  • Facility Phone: 772 837-0500
  • Facility Type: Other - HOME HEALTH AGENCY EXEMPT
  • Facility Type: Waiver
  • Lab Director: JESSICA BURGOS
  • NPI Number: 1366204927
  • Taxonomy: 163WH0200X - Registered Nurse

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2300231
LAB Type Other - HOME HEALTH AGENCY EXEMPT
Facility Name RADIANT RECHARGE LLC
Street 466 SW PORT ST LUCIE BLVD SUITE 114
City PORT SAINT LUCIE
State FL
ZIP 34953
Phone 772 837-0500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/6/2024
Certificate Expiration Date 3/5/2026
Facility Type Other - HOME HEALTH AGENCY EXEMPT
Lab Director JESSICA BURGOS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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