10D2209073 CLIA NUMBER - BRANDYWYNE ASSISTED LIVING FACILITY LLC

Laboratory Demographics

  • CLIA Code: 10D2209073
  • Facility Name: BRANDYWYNE ASSISTED LIVING FACILITY LLC
  • Facility Address: 1801 LAKE MARIAM DR
    WINTER HAVEN, FL
    ZIP 33884
  • Facility Phone: 863 877-0413
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: BASIM SAED
  • NPI Number: 1477060754
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2209073
LAB Type Assisted Living Facility
Facility Name BRANDYWYNE ASSISTED LIVING FACILITY LLC
Street 1801 LAKE MARIAM DR
City WINTER HAVEN
State FL
ZIP 33884
Phone 863 877-0413
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2025
Certificate Expiration Date 1/10/2027
Facility Type Assisted Living Facility
Lab Director BASIM SAED

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