10D0945859 CLIA NUMBER - BROOKDALE FORT MYERS LAKES PARK

Laboratory Demographics

CLIA Number: 10D0945859

Facility Name: BROOKDALE FORT MYERS LAKES PARK

Facility Address:
14521 LAKEWOOD BLVD
FORT MYERS, FL
ZIP 33919
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Facility Phone Number: 239 481-6666

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1679875041

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	10D0945859
LAB Type	Other
Facility Name	BROOKDALE FORT MYERS LAKES PARK
Street	14521 LAKEWOOD BLVD
City	FORT MYERS
State	FL
ZIP	33919
Phone	239 481-6666
CertificateType	4
CertificateEffectiveDate	5/12/2024
CertificateExpirationDate	5/11/2026
FacilityType	Waiver

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