10D1092100 CLIA NUMBER - VILLA COURT LLC

Laboratory Demographics

CLIA Number: 10D1092100

Facility Name: VILLA COURT LLC

Facility Address:
1992 QUEEN ST
N FT MYERS, FL
ZIP 33917
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Facility Phone Number: 239 849-0452

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1528301405

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	10D1092100
LAB Type	Assisted Living Facility
Facility Name	VILLA COURT LLC
Street	1992 QUEEN ST
City	N FT MYERS
State	FL
ZIP	33917
Phone	239 849-0452
CertificateType	4
CertificateEffectiveDate	11/18/2022
CertificateExpirationDate	11/17/2024
FacilityType	Waiver

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