10D2233168 CLIA NUMBER - PALM LAKE VILLAGE HOUSING CORP

Laboratory Demographics

CLIA Number: 10D2233168

Facility Name: PALM LAKE VILLAGE HOUSING CORP

Facility Address:
3800 62ND AVE N
PINELLAS PARK, FL
ZIP 33781
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Facility Phone Number: (727) 489-6440

Facility Type: ASSISTED LIVING FACILITY

Certificate Type: Waiver

NPI Number: 1184962003

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	10D2233168
LAB Type	ASSISTED LIVING FACILITY
Facility Name	PALM LAKE VILLAGE HOUSING CORP
Street	3800 62ND AVE N
City	PINELLAS PARK
State	FL
ZIP	33781
Phone	(727) 489-6440

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This page was last updated on: 5/11/2023