10D1006833 CLIA NUMBER - CEDAR CREEK AT KINGS BAY INC

Laboratory Demographics

CLIA Number: 10D1006833

Facility Name: CEDAR CREEK AT KINGS BAY INC

Facility Address:
231 NW HWY 19
CRYSTAL RIVER, FL
ZIP 34428
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Facility Phone Number: 358 564-2446

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1104262302

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	10D1006833
LAB Type	Assisted Living Facility
Facility Name	CEDAR CREEK AT KINGS BAY INC
Street	231 NW HWY 19
City	CRYSTAL RIVER
State	FL
ZIP	34428
Phone	358 564-2446
CertificateType	4
CertificateEffectiveDate	12/3/2022
CertificateExpirationDate	12/2/2024
FacilityType	Waiver

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