10D0704960 CLIA NUMBER - BROOKSVILLE HEALTHCARE CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D0704960
  • Facility Name: BROOKSVILLE HEALTHCARE CENTER LLC
  • Facility Address: 1114 CHATMAN BOULEVARD
    BROOKSVILLE, FL
    ZIP 34601
  • Facility Phone: 352 796-6701
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CANDY PEDERSEN
  • NPI Number: 1649401324
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D0704960
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BROOKSVILLE HEALTHCARE CENTER LLC
Street 1114 CHATMAN BOULEVARD
City BROOKSVILLE
State FL
ZIP 34601
Phone 352 796-6701
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CANDY PEDERSEN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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