10D2277062 CLIA NUMBER - MIRRAH IMAGE SERVICES LLC

Laboratory Demographics

  • CLIA Code: 10D2277062
  • Facility Name: MIRRAH IMAGE SERVICES LLC
  • Facility Address: 2345 GOLDEN ASTER ST
    CLERMONT, FL
    ZIP 34711
  • Facility Phone: 407 813-2112
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: JENNIFER DICKENS
  • NPI Number: 1104449784
  • Taxonomy: 253Z00000X - In Home Supportive Care

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CLIA Record

Field Name Field Value
CLIA Number 10D2277062
LAB Type Home Health Agency
Facility Name MIRRAH IMAGE SERVICES LLC
Street 2345 GOLDEN ASTER ST
City CLERMONT
State FL
ZIP 34711
Phone 407 813-2112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2025
Certificate Expiration Date 2/20/2027
Facility Type Home Health Agency
Lab Director JENNIFER DICKENS

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