10D2294941 CLIA NUMBER - KIMBERLY REGENESIS, LLC

Laboratory Demographics

  • CLIA Code: 10D2294941
  • Facility Name: KIMBERLY REGENESIS, LLC
  • Facility Address: 6401 WINKER RD
    FORT MYERS, FL
    ZIP 33919
  • Facility Phone: 561 722-8055
  • Facility Type: Other - RESIDENTIAL MENTAL HEALTH
  • Facility Type: Waiver
  • Lab Director: MARY MARGARET MOURACADE
  • NPI Number: 1811342397
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2294941
LAB Type Other - RESIDENTIAL MENTAL HEALTH
Facility Name KIMBERLY REGENESIS, LLC
Street 6401 WINKER RD
City FORT MYERS
State FL
ZIP 33919
Phone 561 722-8055
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/4/2023
Certificate Expiration Date 12/3/2025
Facility Type Other - RESIDENTIAL MENTAL HEALTH
Lab Director MARY MARGARET MOURACADE

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