10D2312387 CLIA NUMBER - REVIVAL MED CENTERS LLC

Laboratory Demographics

  • CLIA Code: 10D2312387
  • Facility Name: REVIVAL MED CENTERS LLC
  • Facility Address: 6262 BIRD RD STE 2K
    MIAMI, FL
    ZIP 33155
  • Facility Phone: 305 692-0421
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ROSA ALBA PEREZ
  • NPI Number: 1871311076
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2312387
LAB Type Practitioner Other
Facility Name REVIVAL MED CENTERS LLC
Street 6262 BIRD RD STE 2K
City MIAMI
State FL
ZIP 33155
Phone 305 692-0421
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2024
Certificate Expiration Date 10/9/2026
Facility Type Practitioner Other
Lab Director ROSA ALBA PEREZ

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