QUIETLY, ABOVE.
PENTHOUSE IV

Your Highest Form.

Monmouth & Ocean County  ·  New Jersey  ·  EST 06/01/26

Physician-led mobile infusion practice.

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What We Are

Longevity medicine,
brought to you.

Physician-led longevity medicine, delivered by licensed nurses, in your own space. Clinical depth, without the clinic.

“This shouldn’t feel like a medical service. It should feel like the most deliberate ritual of your week.”

Founding Philosophy  ·  Penthouse IV
100%
Physician-supervised protocols.
Every session. No exceptions.
Private.
Your space. Your terms.
Complete discretion, always.
On demand.
Same-day availability.
9 AM to 10 PM, seven days.
The Physician

Penthouse IV is a
physician’s practice.

“I have spent twenty-nine years understanding what the body is capable of when it is given what it actually needs.”

Karambir Dalal, M.D.
Medical Director  ·  Internal Medicine
29 years
In clinical practice.
Licensed since 1997.
Board certified.
Internal Medicine.
American Board recognized.
No delegation.
Every protocol authored
and approved personally.
The Process

Three steps.
No clipboards.

I
Intake & Approval

You submit.
Your physician approves.

Five minutes. Reviewed personally. No templates.

II
Arrival & Setup

We come to you.

Your nurse, your home, your terms.

III
Session & Close

The protocol runs.
You receive.

Sixty minutes to four hours. The room becomes the session.

Baseline

You can’t reach your highest form
without knowing where you are.

The Reading
Six Systems · One Sitting

What you’ve never seen
about yourself.

Six systems, read together. Reviewed by your physician. Re-read every quarter.

  • Hormone Endocrine · Cyclical
    Balanced 14 Markers
  • Inflammatory CRP · Homocysteine
    Episodic 06 Markers
  • Metabolic Glucose · Insulin
    Stable 12 Markers
  • Lipid HDL · LDL · ApoB
    Layered 10 Markers
  • Nutrient Vit D · B12 · Mg
    Deficient 18 Markers
  • Thyroid TSH · Free T3 / T4
    Optimal 07 Markers

Eighty markers in total. Reviewed personally by your physician.

01 / Biology
Biological Age Test.
DNA Methylation · Epigenetic Clock
Blood-spot. Analyzed against the published epigenetic clocks. Returns your biological age and pace of aging.
MethodDNA methylation
SampleBlood-spot, mailed
ResultsFour to six weeks
Re-testSix months / one year
02 / Biomarkers
Comprehensive Panel.
Eighty Markers · One Sitting
Hormone, inflammatory, metabolic, lipid, nutrient, and thyroid panels in a single draw. Reviewed personally by the medical director.
Markers~80, full coverage
DrawDuring your IV
ResultsSeven to ten days
ReviewPhysician consultation

Quarterly re-tests track your response. Standalone or as the foundation of a longevity protocol.

What We Offer

Find your
infusion.

Every infusion is built around what your body needs. Select a category. Choose your protocol. Then elevate the ritual around it.

I · Hydration
The Foundation
II · Immune
Defense & Recovery
III · Performance
Built for Output
IV · Beauty
Invest in Biology
Pure Hydration
1L saline with essential electrolytes. Clean, fast, and exactly what your body needs first.
Myers’ Cocktail
The original gold standard. Magnesium, calcium, B-vitamins, vitamin C in one infusion.
Daily Maintenance
B-complex, vitamin C, magnesium, zinc. Your baseline, restored.
Immune Shield
Zinc, selenium, B12, vitamin C, glutathione. Everything your immune system needs at once.
High-Dose Vitamin C
Clinical-grade ascorbic acid at levels no supplement can match. Antioxidant defense at full strength.
Post-Illness Recovery
Rehydration, vitamins, amino acids, anti-inflammatory support. Back to baseline, faster.
Athletic Recovery
Amino acids, electrolytes, B-complex, magnesium. Back to full capacity, faster.
Executive Reset
B12, magnesium, taurine, cognitive support. The clarity you need when you cannot afford to be off.
After Hours
Rapid rehydration, anti-nausea, B-complex. From last night to this morning, handled.
Glow & Radiance
Glutathione, vitamin C, biotin, collagen support. Your skin notices within hours.
Longevity & Anti-Aging
NAD+ precursors, CoQ10, alpha-lipoic acid. Invest in the version of you that does not slow down.
Headache & Migraine
Magnesium, riboflavin, Toradol, anti-nausea support. Fast, targeted, effective.
The Flagship Protocol  ·  Physician-Supervised
NAD+ Infusion
NAD+
Nicotinamide adenine dinucleotide.

NAD+ is the most important molecule
you’ve never heard of.

NAD+ is central to how your cells produce energy, recover, and maintain function over time. It declines by up to 50% between your twenties and sixties, and no oral supplement comes close. IV delivery bypasses everything and reaches the cellular level directly.

Energy
Mitochondrial optimization. Cellular energy restoration.
Cognition
Mental clarity and neural support. Focus at the source, not the symptom.
Recovery
A coenzyme studied within the longevity category. Administered under physician supervision.
Longevity
Sirtuin activation. DNA maintenance support. Molecular-level intervention.
250mg
Starter
Introduction to cellular restoration. First-time protocol.
500mg
Standard
The clinical benchmark. Performance and recovery.
750mg
Elite
Maximum protocol. Deep mitochondrial restoration.
See your biology. Enter your age.
60 seconds. Based on published research.
Restricted Protocol  ·  Physician-Screened
Methylene Blue Infusion
C16H18ClN3S
Methylene Blue
Methylthioninium chloride. FDA-approved for the treatment of methemoglobinemia.

The oldest synthetic drug
in modern medicine.

Synthesized in 1876. FDA-approved for the treatment of methemoglobinemia. Studied across a century and a half of clinical literature for its behavior in the mitochondrial respiratory chain, where it functions as an alternative electron carrier. It accepts electrons upstream and donates them downstream. This redox property is the basis of its scientific interest. Penthouse IV administers methylene blue off-label, under restricted protocol, in physician-screened candidates only. We make no claim of outcome.

Electron Transport
Functions as an alternative carrier between Complexes I and IV of the mitochondrial respiratory chain.
Redox Cycling
Accepts and donates electrons reversibly. The property that defines its biochemical role.
FDA Indication
Approved for the treatment of methemoglobinemia. The legal basis of its pharmaceutical-grade supply.
Off-Label Use
Studied across multiple research domains. Administered here only after physician clearance.
Screening Protocol  ·  Mandatory

No candidate is scheduled
without written clearance.

This protocol is not available through standard intake. Every prospective candidate is reviewed personally by the Medical Director. Each step below is completed before a session is placed on the calendar.

I
Medication Review

Full disclosure of prescription medications, over-the-counter agents, and supplements. Serotonergic exposure is disqualifying pending review.

II
Laboratory Screen

G6PD enzyme assay required. Baseline metabolic and renal function reviewed from records within ninety days, or drawn at intake.

III
Physician Consultation

Direct consultation with Karambir Dalal, M.D. History, indication, and risk profile reviewed in person or by telehealth before any dose is considered.

IV
Written Clearance

Sessions are scheduled only after signed clearance and documented informed consent. Clearance is candidate-specific and dose-specific. It does not transfer between sessions.

Contraindications  ·  Absolute and Relative
Serotonergic Risk

Current or recent use of SSRIs, SNRIs, MAOIs, tricyclic antidepressants, bupropion, triptans, tramadol, lithium, or St. John’s Wort. Methylene blue is a potent MAO inhibitor. Combined exposure carries documented risk of serotonin syndrome.

Hematologic and Renal

G6PD deficiency. Hemolytic anemia. Methemoglobin reductase deficiency. Severe renal impairment. Documented hypersensitivity to phenothiazine compounds. Sulfite sensitivity.

Life Stage

Pregnancy. Breastfeeding. Age under eighteen. Planned conception is reviewed individually with the Medical Director prior to any session.

Disclosure and Washout

Incomplete medication disclosure is disqualifying. Washout periods for serotonergic medications follow current pharmacologic guidance and are set case by case by the Medical Director.

Available exclusively within The Penthouse Experience.
Paired with NAD+ as The Cellular Reset.
Not bookable through standard intake. Not promotable to candidates outside the screening pathway above. Final scheduling rests with the Medical Director.
Enhancement  ·  Sound Environment
The Sound Environment

An atmosphere
for the hour.

Every session is paired with an optional ambient sound environment, generated live and chosen to suit the character of your hour. Delivered through premium wired headphones, or through the room if you prefer nothing on the body. Offered for comfort. Not a medical treatment.

Delivery  ·  Choose One
I.
Binaural
Premium wired over-ear headphones

Two close tones, one to each ear. The ear perceives a slow pulse at the difference between them. Wired only, to keep nothing wireless near you during your session.

or
II.
Through the Room
Ambient · hands-free

A soft pulsed tone carried through the room. No headphones, no cord. For those who prefer nothing on the body.

Hear It  ·  Generated Live
6Hz
Theta
Slow & spacious
NAD+ & Longevity6 HzThetaSlow & spacious
Athletic Recovery10 HzAlphaOpen & light
Executive Reset2 HzDeltaLow & deep
Best with headphones · Ambient sound, offered for comfort. Not a medical treatment.
Enhancement  ·  Photonic Protocol
Red Light Therapy

Your cells
on light.

Two wavelengths of light, red and near-infrared, delivered from a medical-grade panel positioned above the chair and activated when your session begins. Red-light and near-infrared therapy is an area of active scientific study. We make no claim of outcome. Offered as part of the experience.

Wavelengths  ·  Delivered Simultaneously
660
Red
Surface · Skin · Collagen

A visible wavelength absorbed at the surface of the skin. Studied widely for its interaction with skin tissue.

+
850
Near-Infrared
Depth · Muscle · Mitochondria

A longer wavelength that reaches deeper tissue. Studied for its interaction with cells at depth.

Emphasis  ·  Matched to Protocol
NAD+ 850nm 850nmNear-infrared emphasis.
Beauty & Longevity 660nm 660nmRed emphasis.
Athletic Recovery 660 + 850nm BothRed and near-infrared.
Executive Reset 850nm 850nmNear-infrared emphasis.
Compose

Compose your
infusion.

Choose a base, then layer in what you'd like. The bag composes itself with each addition, so you can see your infusion take shape. A starting point for the conversation with your physician, never a prescription.

Saline Base
No additions yet
A preference, not a prescription.
Final formulation determined by your physician.
Base Bag
0 of 4 additions
A composed infusion holds up to four additions. Beyond that, your physician will advise on what's appropriate.
The Collection

Three tiers.
One standard.

Every session begins with clinical precision. What separates the tiers is how deep the experience goes — and how often you choose to return.

I
Essential
The Essential Drip

The clean baseline. Nothing less than the standard.

  • 1-liter IV base with Vitamin C, B-Complex, electrolytes
  • One signature enhancement of your choosing
  • The Penthouse Closet welcome set on first visit
Duration
45-60 min
Enhancements
One
Access
Standard
II
Elevated
The Elevated Drip

Therapeutic cocktail. Full experience layer. The standard rises.

  • Myers’ Cocktail base with vitals assessment
  • Two enhancements of your choosing
  • Red light, NormaTec compression, neural entrainment
Duration
60-75 min
Enhancements
Two
Access
Standard
The standard.
III
Penthouse
The Penthouse Experience

The full expression. Concierge care from arrival to aftercare.

  • Premium IV base with executive cocktail
  • Three enhancements, NAD+ available by request
  • Complete ritual, The Penthouse Closet welcome set, gift set, take-home protocol
Duration
90 min to 4 hrs
Enhancements
Three + NAD+
Access
Priority

For those who want this to be part of how they live. Three tiers, each a different relationship with the protocol. Every membership includes physician-supervised sessions, quarterly biomarker calibration, and access to the Apothecary.

Essential
The Monthly Drip

The protocol introduction.

  • One Essential Drip per month
  • Priority scheduling
  • Apothecary access at member rates
  • Member-exclusive rates on additional sessions
  • Quarterly biomarker re-test
  • Cancel anytime
Black Card
The Monthly Access

The personal protocol.

  • Two Elevated sessions monthly · full menu access
  • Priority scheduling
  • Biweekly Top Floor Provisions box · single · forthcoming
  • Seasonal menu, member-curated
  • Enhanced member rates
  • Session credit rollover
  • Quarterly biomarker re-test
  • Cancel anytime
The standard.
Elite
The Elite Access

The household protocol.

  • Four Penthouse sessions monthly · full menu access
  • Priority same-day scheduling
  • Biweekly Top Floor Provisions box · family-sized · forthcoming
  • Seasonal menu, member-curated
  • Top Floor Omakase plated with every session, scaled to party size · forthcoming
  • NAD+ protocol access
  • Dedicated household concierge
  • Maximum member rates
  • Quarterly biomarker re-test
  • Cancel anytime
Groups & Events
Your Circle
  • Private group delivery for up to four guests
  • Corporate events, retreats, and private functions up to fifteen
  • One arrival window. One setup. Discounted per-person rate
  • Full menu, full experience, delivered on-site

Rates and availability upon request. Inquire here.

The Enhancement Menu

Add exactly
what you need.

Selected for your session and administered in the room. Physician-approved. Nurse-administered. Exactly when your body needs it.

I · Clinical
Glutathione Push
The master antioxidant. Oxidative defense, skin luminance, and free radical neutralization delivered in a single push.
Toradol
Pharmaceutical-grade anti-inflammatory. Immediate pain and headache relief without sedation.
Zofran
Prescription-strength anti-nausea. Rapid onset. No sedation. Clinically proven and physician-ordered.
Amino Acid Complex
Muscle preservation, tissue repair, and neurotransmitter synthesis. The building blocks, delivered directly.
II · Cellular
NAD+ Boost
250mg of cellular fuel delivered intravenously. Energy, cognitive clarity, and recovery acceleration.
CoQ10
Mitochondrial fuel and cardiovascular support. Cellular energy optimization at the source.
Alpha-Lipoic Acid
Universal antioxidant. Metabolic support, neural support, and glucose metabolism support in a single push.
Magnesium
Muscle recovery, nervous system calm, migraine suppression, and sleep quality. All in one mineral.
III · Aesthetic & Immune
Biotin
Skin, hair, and nail fortification at the cellular level. Metabolic support and enzymatic efficiency.
Vitamin D3
Immune system support, bone health, hormonal balance, and mood regulation. The deficiency most people do not know they have.
B12 Methylcobalamin
Energy at the neural level. Mood regulation, nerve function, and red blood cell optimization. The clean version.
Zinc Boost
Immune fortification, tissue recovery support, and hormonal balance in a single IV push.
Elite Tier  ·  The Penthouse Experience
The Flow

Every moment.
Accounted for.

Most clients book because of the infusion. They return because of what happens around it. This is every moment of the Penthouse Experience, from the doorbell to the door closing behind her.

Arrival

The door opens. The session begins.

Your nurse arrives on time in premium black Penthouse IV scrubs. No clipboard, no fluorescent energy. She greets you by name. You will not be asked to fill out a single form. Everything has been handled.

Licensed RN Arrival Window Locked Zero Paperwork
Presentation

The robe. The slippers.

A heavyweight black velour robe, woven by the same atelier that supplies Aman, Ritz-Carlton, Mandarin Oriental, and St. Regis. Closed-toe slippers, embroidered to match. Presented on arrival, yours to change into. The session does not begin in what you came home in. It begins in something from The Penthouse Closet, made for this session.

Cotton Velour Hotel-Atelier Made Yours on First Visit
Preparation

Vitals. Vein. Protocol confirmed.

Blood pressure. Oxygen. Heart rate. A quiet two-minute pre-session review. Your protocol, signed off by the physician in advance, is confirmed one more time at the chairside. The IV is placed with precision. You barely feel it.

Physician-Signed Protocol Vitals Documented Single-Stick Standard
Environment

The room becomes the room.

Lights dim to candle level. The red light therapy panel activates. A weighted lap wrap. An aromatherapy neck wrap. A gold collagen mask placed at the hairline. Premium wired over-ear headphones lowered over your ears. The outside world is gone.

Red Light Therapy Weighted Wrap Gold Collagen Mask Wired Premium Over-Ear
Infusion

The drip. The frequency.

Your infusion begins. An optional ambient sound environment flows through the headphones, chosen to suit the character of your hour. A slow tone for stillness, a lighter one to lift, a low one to settle.

Protocol-Matched Audio NormaTec Activated Silent Delivery
Closure

The line is out. The sauna begins.

The infusion completes. The IV is removed cleanly. A final vitals check. Then the infrared sauna blanket wraps around you for twenty minutes of circulation and recovery while the nurse resets the space and prepares your gift set.

Infrared Blanket Post-Session Vitals 20 Minutes of Quiet
Departure

She leaves. You stay changed.

The nurse packs out. The space is returned to you exactly as it was found, but you are not. A silk sleep mask, a self-care travel kit, and an insulated Penthouse bottle remain on the counter. That is the gift set. The time is yours to keep.

Silk Sleep Mask Travel Kit Insulated Bottle Space Reset

We told you every moment would be accounted for. This is what we meant.

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XIII·BY ALLOCATION

The Apothecary

apothecary · n.not a store, but a place where remedies are composed by hand and kept for the few.

What the residence provides. Provisions from a single New Jersey farm. Omakase plated alongside the session. Tinctures sealed in matte black glass. All three are being composed now, and open with the practice.

ENTER THE APOTHECARY
By allocation · Yours, in residence
XIV·THE PENTHOUSE CLOSET·WORN HERE

The wardrobe of the residence.

Considered apparel from the same atelier that supplies Aman, Ritz-Carlton, Mandarin Oriental, St. Regis. Worn during the session. Worn after.

I
The Welcome Set
The robe. The slippers.

Heavyweight matte black velour. Antique gold embroidery at the chest. Closed-toe slippers, embroidered to match. Presented on arrival, yours to keep. The session does not begin in what you came home in.

Included · Penthouse Experience
II
The Lifestyle Line
Worn off duty.

Caps, oversized tees, sweatshirts, branded scrubs. Same matte black, same antique gold mark. The Penthouse Closet outside the session, in the residence, on the street, at the gym, anywhere the standard goes.

Buy direct · Member rates available
Status

Launching alongside the practice.

The Welcome Set arrives with every Penthouse Experience from day one. The lifestyle line opens to the public in waves through 2026.

By request
Where We Operate

We come
to you.

Monmouth & Ocean County. Wherever you’re staying. Whenever you’re ready.

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Tap a town
Tap any town on the map.
By request
Coverage
Full menu, all tiers
Availability
Same-day service
Access
Standard & Elite
Your Highest Form

Your highest
form awaits.

Invitation-only. By request.
Monmouth & Ocean County, New Jersey.

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Penthouse IV services are provided under the supervision of a licensed New Jersey physician. All IV therapy protocols are administered by licensed registered nurses operating under physician standing orders. Services are not a substitute for emergency medical care. Consult your physician before beginning any IV therapy protocol. Individual results may vary. These statements have not been evaluated by the Food and Drug Administration. These services are not intended to diagnose, treat, cure, or prevent any disease.
© 2026 Penthouse IV LLC  ·  IV Direct P.C.  ·  Physician-Led  ·  Licensed Nurses  ·  New Jersey