10D1029626 CLIA NUMBER - MADISON AT CLERMONT

Laboratory Demographics

CLIA Number: 10D1029626

Facility Name: MADISON AT CLERMONT

Facility Address:
650 E MINNEHAHA AVE
CLERMONT, FL
ZIP 34711
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Facility Phone Number: 352 241-0844

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1023227865

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	10D1029626
LAB Type	Assisted Living Facility
Facility Name	MADISON AT CLERMONT
Street	650 E MINNEHAHA AVE
City	CLERMONT
State	FL
ZIP	34711
Phone	352 241-0844
CertificateType	4
CertificateEffectiveDate	8/19/2022
CertificateExpirationDate	8/18/2024
FacilityType	Waiver

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