10D2315316 CLIA NUMBER - EVOLVE WELLNESS AND RECOVERY LLC

Laboratory Demographics

  • CLIA Code: 10D2315316
  • Facility Name: EVOLVE WELLNESS AND RECOVERY LLC
  • Facility Address: 4161 NW 5TH ST STE 201
    PLANTATION, FL
    ZIP 33317
  • Facility Phone: 954 859-6051
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEVEN SUASTEGUI
  • NPI Number: 1154177012
  • Taxonomy: 207RA0401X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2315316
LAB Type Physician Office
Facility Name EVOLVE WELLNESS AND RECOVERY LLC
Street 4161 NW 5TH ST STE 201
City PLANTATION
State FL
ZIP 33317
Phone 954 859-6051
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2024
Certificate Expiration Date 12/10/2026
Facility Type Physician Office
Lab Director STEVEN SUASTEGUI

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