10D0976049 CLIA NUMBER - BROOKDALE LAKE TAVARES

Laboratory Demographics

  • CLIA Code: 10D0976049
  • Facility Name: BROOKDALE LAKE TAVARES
  • Facility Address: 1211 E CAROLINE ST
    TAVARES, FL
    ZIP 32778
  • Facility Phone: 352 343-6464
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: DEBORAH BERTINI
  • NPI Number: 1568764991
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D0976049
LAB Type Other
Facility Name BROOKDALE LAKE TAVARES
Street 1211 E CAROLINE ST
City TAVARES
State FL
ZIP 32778
Phone 352 343-6464
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/24/2024
Certificate Expiration Date 7/23/2026
Facility Type Other
Lab Director DEBORAH BERTINI

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