CLIA lab
CLIA 10D2176100: Intrepid Detox Residential LLC
Mangonia Park, FL. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 10D2176100 belongs to Intrepid Detox Residential LLC in Mangonia Park, FL.
Certificate of Waiver, effective December 9, 2025, expires December 8, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- December 9, 2025
- Certificate expiration
- December 8, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- December 9, 2019
- Facility type
- Other
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 10D2176100
- Lab name
- Intrepid Detox Residential LLC
- Address
- 1120 48th Street, Mangonia Park, FL 33407
- Phone
- (646) 645-7773
- Fax
- (561) 516-8799
Annual test volume the lab reported
- Waived tests
- 700
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Intrepid Detox Residential LLC in Mangonia Park?
10D2176100, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Intrepid Detox Residential LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 10D2176100 expire?
The CMS file lists December 8, 2027 as the certificate expiration date; the certificate took effect December 9, 2025.