10D0982540 CLIA NUMBER - EC OPCO TIMBERLIN PARC LLC DBA ELMCROFT OF TIMBERLIN PARC

Laboratory Demographics

CLIA Number: 10D0982540

Facility Name: EC OPCO TIMBERLIN PARC LLC DBA ELMCROFT OF TIMBERLIN PARC

Facility Address:
7620 TIMBERLIN PARK BLVD
JACKSONVILLE, FL
ZIP 32256
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Facility Phone Number: 904 519-9300

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1639670847

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	10D0982540
LAB Type	Assisted Living Facility
Facility Name	EC OPCO TIMBERLIN PARC LLC DBA ELMCROFT OF TIMBERLIN PARC
Street	7620 TIMBERLIN PARK BLVD
City	JACKSONVILLE
State	FL
ZIP	32256
Phone	904 519-9300
CertificateType	4
CertificateEffectiveDate	1/30/2023
CertificateExpirationDate	1/29/2025
FacilityType	Waiver

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