10D1096621 CLIA NUMBER - LHCG CLVI LLC DBA MEDERI CARETENDERS

Laboratory Demographics

  • CLIA Code: 10D1096621
  • Facility Name: LHCG CLVI LLC DBA MEDERI CARETENDERS
  • Facility Address: 1167 MIRANDA LN
    KISSIMMEE, FL
    ZIP 34741
  • Facility Phone: 407 931-0487
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: DOUGLAS O LEARY
  • NPI Number: 1639703218
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 10D1096621
LAB Type Home Health Agency
Facility Name LHCG CLVI LLC DBA MEDERI CARETENDERS
Street 1167 MIRANDA LN
City KISSIMMEE
State FL
ZIP 34741
Phone 407 931-0487
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Home Health Agency
Lab Director DOUGLAS O LEARY

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