10D2158733 CLIA NUMBER - ISM-HERITAGE HOUSE ALF LLC

Laboratory Demographics

CLIA Number: 10D2158733

Facility Name: ISM-HERITAGE HOUSE ALF LLC

Facility Address:
1810 S BELCHER RD
CLEARWATER, FL
ZIP 33764
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Facility Phone Number: 727 531-2236

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1689188963

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	10D2158733
LAB Type	Assisted Living Facility
Facility Name	ISM-HERITAGE HOUSE ALF LLC
Street	1810 S BELCHER RD
City	CLEARWATER
State	FL
ZIP	33764
Phone	727 531-2236
CertificateType	4
CertificateEffectiveDate	12/5/2022
CertificateExpirationDate	12/4/2024
FacilityType	Waiver

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