10D0992275 CLIA NUMBER - EVERGREEN WOODS OWNER LLC DBA VITALITY LIVING SPRING HILL

Laboratory Demographics

CLIA Number: 10D0992275

Facility Name: EVERGREEN WOODS OWNER LLC DBA VITALITY LIVING SPRING HILL

Facility Address:
7030 EVERGREEN WOODS TRAIL
SPRING HILL, FL
ZIP 34608
Get Directions

Facility Phone Number: 352 596-2055

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1649574419

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	10D0992275
LAB Type	Assisted Living Facility
Facility Name	EVERGREEN WOODS OWNER LLC DBA VITALITY LIVING SPRING HILL
Street	7030 EVERGREEN WOODS TRAIL
City	SPRING HILL
State	FL
ZIP	34608
Phone	352 596-2055
CertificateType	4
CertificateEffectiveDate	10/13/2022
CertificateExpirationDate	10/12/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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