10D2104378 CLIA NUMBER - REGENCY PARK

Laboratory Demographics

CLIA Number: 10D2104378

Facility Name: REGENCY PARK

Facility Address:
15000 HIGHWAY 441
EUSTIS, FL
ZIP 32726
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Facility Phone Number: 352 609-2040

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1396196861

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	10D2104378
LAB Type	Assisted Living Facility
Facility Name	REGENCY PARK
Street	15000 HIGHWAY 441
City	EUSTIS
State	FL
ZIP	32726
Phone	352 609-2040
CertificateType	4
CertificateEffectiveDate	11/3/2023
CertificateExpirationDate	11/2/2025
FacilityType	Waiver

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