10D2112546 CLIA NUMBER - GRAND VILLA OF DELAND

Laboratory Demographics

CLIA Number: 10D2112546

Facility Name: GRAND VILLA OF DELAND

Facility Address:
350 E INTERNATIONAL SPEEDWAY BLVD
DELAND, FL
ZIP 32724
Get Directions

Facility Phone Number: 386 738-5200

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1770958142

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	10D2112546
LAB Type	Assisted Living Facility
Facility Name	GRAND VILLA OF DELAND
Street	350 E INTERNATIONAL SPEEDWAY BLVD
City	DELAND
State	FL
ZIP	32724
Phone	386 738-5200
CertificateType	4
CertificateEffectiveDate	5/3/2024
CertificateExpirationDate	5/2/2026
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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