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10D1006506 CLIA NUMBER - LEE MEMORIAL HEALTH SYSTEMS HOME HEALTH

Laboratory Demographics

CLIA Number: 10D1006506

Facility Name: LEE MEMORIAL HEALTH SYSTEMS HOME HEALTH

Facility Address:
12801 WESTLINKS DRIVE
FORT MYERS, FL
ZIP 33913
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Facility Phone Number: 239 225-7695

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1689672065

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 10D1006506
LAB Type Home Health Agency
Facility Name LEE MEMORIAL HEALTH SYSTEMS HOME HEALTH
Street 12801 WESTLINKS DRIVE
City FORT MYERS
State FL
ZIP 33913
Phone 239 225-7695
CertificateType 4
CertificateEffectiveDate 11/25/2022
CertificateExpirationDate 11/24/2024
FacilityType Waiver

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