10D1000141 CLIA NUMBER - LAKE FOREST OWNER LLC

Laboratory Demographics

  • CLIA Code: 10D1000141
  • Facility Name: LAKE FOREST OWNER LLC
  • Facility Address: 5433 WEST STATE ROAD 46
    SANFORD, FL
    ZIP 32771
  • Facility Phone: 407 322-2207
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: TERESA E. MENA
  • NPI Number: 1982225132
  • Taxonomy: 1223E0200X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 10D1000141
LAB Type Assisted Living Facility
Facility Name LAKE FOREST OWNER LLC
Street 5433 WEST STATE ROAD 46
City SANFORD
State FL
ZIP 32771
Phone 407 322-2207
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/15/2024
Certificate Expiration Date 10/14/2026
Facility Type Assisted Living Facility
Lab Director TERESA E. MENA

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