10D2194140 CLIA NUMBER - 360 HOME HEALTHCARE AGENCY INC

Laboratory Demographics

  • CLIA Code: 10D2194140
  • Facility Name: 360 HOME HEALTHCARE AGENCY INC
  • Facility Address: 3611 LEE BLVD
    LEHIGH ACRES, FL
    ZIP 33971
  • Facility Phone: 239 694-9102
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: AXEL RUIZ
  • NPI Number: 1811528003
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 10D2194140
LAB Type Home Health Agency
Facility Name 360 HOME HEALTHCARE AGENCY INC
Street 3611 LEE BLVD
City LEHIGH ACRES
State FL
ZIP 33971
Phone 239 694-9102
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2024
Certificate Expiration Date 9/28/2026
Facility Type Home Health Agency
Lab Director AXEL RUIZ

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