CLIA lab
CLIA 11D2174120: Ithrive Health & Wellness, LLC
Lake Park, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D2174120 belongs to Ithrive Health & Wellness, LLC in Lake Park, GA.
Certificate of Waiver, effective October 24, 2025, expires October 23, 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
- October 24, 2025
- Certificate expiration
- October 23, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- October 24, 2019
- Facility type
- Other practitioner
- 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
- 11D2174120
- Lab name
- Ithrive Health & Wellness, LLC
- Address
- 5715 Gardenia Circle, Lake Park, GA 31636
- Phone
- (229) 375-0475
- Fax
- (229) 389-2274
Annual test volume the lab reported
- Waived tests
- 500
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 Ithrive Health & Wellness, LLC in Lake Park?
11D2174120, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Ithrive Health & Wellness, LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 11D2174120 expire?
The CMS file lists October 23, 2027 as the certificate expiration date; the certificate took effect October 24, 2025.