10D0874007 CLIA NUMBER - LAKE PORT SQUARE HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 10D0874007
  • Facility Name: LAKE PORT SQUARE HEALTH CENTER
  • Facility Address: 701 LAKE PORT BLVD
    LEESBURG, FL
    ZIP 34748
  • Facility Phone: 352 728-8525
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHARLENE WEBSTER
  • NPI Number: 1073927331
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D0874007
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LAKE PORT SQUARE HEALTH CENTER
Street 701 LAKE PORT BLVD
City LEESBURG
State FL
ZIP 34748
Phone 352 728-8525
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2025
Certificate Expiration Date 8/3/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CHARLENE WEBSTER

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