10D0948637 CLIA NUMBER - PACIFICA SENIOR LIVING FORT MYERS

Laboratory Demographics

CLIA Number: 10D0948637

Facility Name: PACIFICA SENIOR LIVING FORT MYERS

Facility Address:
9461 HEALTH PARK CIR
FORT MYERS, FL
ZIP 33908
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Facility Phone Number: 239 437-5511

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1679984389

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	10D0948637
LAB Type	Assisted Living Facility
Facility Name	PACIFICA SENIOR LIVING FORT MYERS
Street	9461 HEALTH PARK CIR
City	FORT MYERS
State	FL
ZIP	33908
Phone	239 437-5511
CertificateType	4
CertificateEffectiveDate	7/16/2022
CertificateExpirationDate	7/15/2024
FacilityType	Waiver

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