10D2121231 CLIA NUMBER - DIVINITY HOME HEALTHCARE LLC

Laboratory Demographics

  • CLIA Code: 10D2121231
  • Facility Name: DIVINITY HOME HEALTHCARE LLC
  • Facility Address: 2001 WELLS RD
    ORANGE PARK, FL
    ZIP 32073
  • Facility Phone: 904 900-8073
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: GERT J. LOUIS
  • NPI Number: 1093168924
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 10D2121231
LAB Type Home Health Agency
Facility Name DIVINITY HOME HEALTHCARE LLC
Street 2001 WELLS RD
City ORANGE PARK
State FL
ZIP 32073
Phone 904 900-8073
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Home Health Agency
Lab Director GERT J. LOUIS

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