10D0918189 CLIA NUMBER - ALDEA GREEN

Laboratory Demographics

CLIA Number: 10D0918189

Facility Name: ALDEA GREEN

Facility Address:
700 S KINGS AVE
BRANDON, FL
ZIP 33511
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Facility Phone Number: 813 662-0255

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1457571242

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	10D0918189
LAB Type	Assisted Living Facility
Facility Name	ALDEA GREEN
Street	700 S KINGS AVE
City	BRANDON
State	FL
ZIP	33511
Phone	813 662-0255
CertificateType	4
CertificateEffectiveDate	8/2/2022
CertificateExpirationDate	8/1/2024
FacilityType	Waiver

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