44D2268468 CLIA NUMBER - REVIDA RECOVERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 44D2268468
  • Facility Name: REVIDA RECOVERY CENTER, LLC
  • Facility Address: 712 PROFESSIONAL PLAZA DRIVE
    GREENEVILLE, TN
    ZIP 37745
  • Facility Phone: 423 820-0432
  • Facility Type: Other - OBOT
  • Facility Type: Waiver
  • Lab Director: RANDY DURBIN
  • NPI Number: 1013483486
  • Taxonomy: 207QA0401X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 44D2268468
LAB Type Other - OBOT
Facility Name REVIDA RECOVERY CENTER, LLC
Street 712 PROFESSIONAL PLAZA DRIVE
City GREENEVILLE
State TN
ZIP 37745
Phone 423 820-0432
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2024
Certificate Expiration Date 9/12/2026
Facility Type Other - OBOT
Lab Director RANDY DURBIN

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