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10D0881520 CLIA NUMBER - MEDERI CARETENDERS VS OF SW FL, LLC DBA MEDERI CARETENDERS

Laboratory Demographics

CLIA Number: 10D0881520

Facility Name: MEDERI CARETENDERS VS OF SW FL, LLC DBA MEDERI CARETENDERS

Facility Address:
6150 DIAMOND CENTER CT STE A
FORT MYERS, FL
ZIP 33912
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Facility Phone Number: 239 481-5999

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1942481759

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 10D0881520
LAB Type Home Health Agency
Facility Name MEDERI CARETENDERS VS OF SW FL, LLC DBA MEDERI CARETENDERS
Street 6150 DIAMOND CENTER CT STE A
City FORT MYERS
State FL
ZIP 33912
Phone 239 481-5999
CertificateType 4
CertificateEffectiveDate 1/11/2024
CertificateExpirationDate 1/10/2026
FacilityType Waiver

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