10D2046697 CLIA NUMBER - SUPERIOR RESIDENCES OF LECANTO

Laboratory Demographics

  • CLIA Code: 10D2046697
  • Facility Name: SUPERIOR RESIDENCES OF LECANTO
  • Facility Address: 4865 W GULF TO LAKE HWY
    LECANTO, FL
    ZIP 34461
  • Facility Phone: 352 746-5483
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: SHANNON VINSONHALER
  • NPI Number: 1669962155
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2046697
LAB Type Assisted Living Facility
Facility Name SUPERIOR RESIDENCES OF LECANTO
Street 4865 W GULF TO LAKE HWY
City LECANTO
State FL
ZIP 34461
Phone 352 746-5483
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2024
Certificate Expiration Date 9/9/2026
Facility Type Assisted Living Facility
Lab Director SHANNON VINSONHALER

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