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11D2291783 CLIA NUMBER - REVIVE HEALTH CARE SOLUTIONS, LLC

Laboratory Demographics

CLIA Number: 11D2291783

Facility Name: REVIVE HEALTH CARE SOLUTIONS, LLC

Facility Address:
100 GRACE HOPPER LN, SUITE 3763
AUGUSTA, GA
ZIP 30901
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Facility Phone Number: 877 777-9740

Facility Type: Independent

Certificate Type: Waiver
NPI Number: 1316719248

Taxonomy: 291U00000X - Clinical Medical Laboratory
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

CLIA Record

Field Name Field Value
CLIA Number 11D2291783
LAB Type Independent
Facility Name REVIVE HEALTH CARE SOLUTIONS, LLC
Street 100 GRACE HOPPER LN, SUITE 3763
City AUGUSTA
State GA
ZIP 30901
Phone 877 777-9740
CertificateType 4
CertificateEffectiveDate 10/16/2023
CertificateExpirationDate 10/15/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024