34D2328997 CLIA NUMBER - FRESH START REHAB LLC

Laboratory Demographics

  • CLIA Code: 34D2328997
  • Facility Name: FRESH START REHAB LLC
  • Facility Address: 624 S FAYETTEVILLE STREET STE C
    CEDAR FALLS, NC
    ZIP 27230
  • Facility Phone: 743 224-7107
  • Facility Type: Other - SAIOP
  • Facility Type: Waiver
  • Lab Director: JARIKSA MENJIVAR
  • NPI Number: 1033093158
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D2328997
LAB Type Other - SAIOP
Facility Name FRESH START REHAB LLC
Street 624 S FAYETTEVILLE STREET STE C
City CEDAR FALLS
State NC
ZIP 27230
Phone 743 224-7107
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2025
Certificate Expiration Date 8/19/2027
Facility Type Other - SAIOP
Lab Director JARIKSA MENJIVAR

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