10D2328730 CLIA NUMBER - REVIVE SURGICENTER LLC

Laboratory Demographics

  • CLIA Code: 10D2328730
  • Facility Name: REVIVE SURGICENTER LLC
  • Facility Address: 1347 E SAMPLE ROAD, SUITE B
    POMPANO BEACH, FL
    ZIP 33064
  • Facility Phone: 754 331-0168
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DANE C. POHLMAN
  • NPI Number: 1023816774
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2328730
LAB Type Ambulatory Surgery Center
Facility Name REVIVE SURGICENTER LLC
Street 1347 E SAMPLE ROAD, SUITE B
City POMPANO BEACH
State FL
ZIP 33064
Phone 754 331-0168
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2025
Certificate Expiration Date 8/14/2027
Facility Type Ambulatory Surgery Center
Lab Director DANE C. POHLMAN

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