10D2200289 CLIA NUMBER - SUMTER PLACE OWNER LLC

Laboratory Demographics

  • CLIA Code: 10D2200289
  • Facility Name: SUMTER PLACE OWNER LLC
  • Facility Address: 1550 KILLINGSWORTH WAY
    THE VILLAGES, FL
    ZIP 32162
  • Facility Phone: 352 674-3600
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MICA GILLES
  • NPI Number: 1023405446
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2200289
LAB Type Assisted Living Facility
Facility Name SUMTER PLACE OWNER LLC
Street 1550 KILLINGSWORTH WAY
City THE VILLAGES
State FL
ZIP 32162
Phone 352 674-3600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2024
Certificate Expiration Date 11/12/2026
Facility Type Assisted Living Facility
Lab Director MICA GILLES

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