10D0689666 CLIA NUMBER - LHCG CLV LLC DBA MEDERI CARETENDERS

Laboratory Demographics

CLIA Number: 10D0689666

Facility Name: LHCG CLV LLC DBA MEDERI CARETENDERS

Facility Address:
2400 SOUTH HIGHWAY 27 SUITE 4306
CLERMONT, FL
ZIP 34711
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Facility Phone Number: 352 323-5570

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1649804220

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name	Field Value
CLIA Number	10D0689666
LAB Type	Home Health Agency
Facility Name	LHCG CLV LLC DBA MEDERI CARETENDERS
Street	2400 SOUTH HIGHWAY 27 SUITE 4306
City	CLERMONT
State	FL
ZIP	34711
Phone	352 323-5570
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024