10D0936063 CLIA NUMBER - AUTUMN HOUSE HOLDCO LLC

Laboratory Demographics

  • CLIA Code: 10D0936063
  • Facility Name: AUTUMN HOUSE HOLDCO LLC
  • Facility Address: 7999 SPYGLASS HILL ROAD
    MELBOURNE, FL
    ZIP 32940
  • Facility Phone: 321 242-1006
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: JOY HINES
  • NPI Number: 1457756652
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D0936063
LAB Type Assisted Living Facility
Facility Name AUTUMN HOUSE HOLDCO LLC
Street 7999 SPYGLASS HILL ROAD
City MELBOURNE
State FL
ZIP 32940
Phone 321 242-1006
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2023
Certificate Expiration Date 11/13/2025
Facility Type Assisted Living Facility
Lab Director JOY HINES

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