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10D2195588 CLIA NUMBER - LHCG CLIV LLC DBA MEDERI CARETENDERS

Laboratory Demographics

CLIA Number: 10D2195588

Facility Name: LHCG CLIV LLC DBA MEDERI CARETENDERS

Facility Address:
1635 E HIGHWAY 50 SUITE 100
CLERMONT, FL
ZIP 34711
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Facility Phone Number: 352 241-7138

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1063045961

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 10D2195588
LAB Type Home Health Agency
Facility Name LHCG CLIV LLC DBA MEDERI CARETENDERS
Street 1635 E HIGHWAY 50 SUITE 100
City CLERMONT
State FL
ZIP 34711
Phone 352 241-7138
CertificateType 4
CertificateEffectiveDate 10/9/2022
CertificateExpirationDate 10/8/2024
FacilityType Waiver

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