10D2314650 CLIA NUMBER - MIRACLES RECOVERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D2314650
  • Facility Name: MIRACLES RECOVERY CENTER LLC
  • Facility Address: 584 NW UNIVERSITY BLVD STE 400
    PORT SAINT LUCIE, FL
    ZIP 34986
  • Facility Phone: 772 249-4988
  • Facility Type: Other - SUBSTANCE USE TREATMENT
  • Facility Type: Waiver
  • Lab Director: JEFFREY BLOSSOM
  • NPI Number: 1356819650
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2314650
LAB Type Other - SUBSTANCE USE TREATMENT
Facility Name MIRACLES RECOVERY CENTER LLC
Street 584 NW UNIVERSITY BLVD STE 400
City PORT SAINT LUCIE
State FL
ZIP 34986
Phone 772 249-4988
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/25/2024
Certificate Expiration Date 11/24/2026
Facility Type Other - SUBSTANCE USE TREATMENT
Lab Director JEFFREY BLOSSOM

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