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10D2094078 CLIA NUMBER - LEE MEMORIAL HEALTH SYSTEM D/B/A LPG FAMILY MEDICINE AT PLANTATION

Laboratory Demographics

CLIA Number: 10D2094078

Facility Name: LEE MEMORIAL HEALTH SYSTEM D/B/A LPG FAMILY MEDICINE AT PLANTATION

Facility Address:
13782 PLANTATION ROAD #201
FORT MYERS, FL
ZIP 33912
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Facility Phone Number: 239 343-2095

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1114409141

Taxonomy: 314000000X - Skilled Nursing Facility
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

CLIA Record

Field Name Field Value
CLIA Number 10D2094078
LAB Type Physician Office
Facility Name LEE MEMORIAL HEALTH SYSTEM D/B/A LPG FAMILY MEDICINE AT PLANTATION
Street 13782 PLANTATION ROAD #201
City FORT MYERS
State FL
ZIP 33912
Phone 239 343-2095
CertificateType 4
CertificateEffectiveDate 2/4/2024
CertificateExpirationDate 2/3/2026
FacilityType Waiver

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