10D2313568 CLIA NUMBER - ATLANTIC CARE HOME HEALTH JACKSONVILLE LLC

Laboratory Demographics

  • CLIA Code: 10D2313568
  • Facility Name: ATLANTIC CARE HOME HEALTH JACKSONVILLE LLC
  • Facility Address: 728 FENTRESS BLVD
    DAYTONA BEACH, FL
    ZIP 32114
  • Facility Phone: 407 270-5501
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: JEN CEBALLOS
  • NPI Number: 1508473745
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 10D2313568
LAB Type Home Health Agency
Facility Name ATLANTIC CARE HOME HEALTH JACKSONVILLE LLC
Street 728 FENTRESS BLVD
City DAYTONA BEACH
State FL
ZIP 32114
Phone 407 270-5501
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2024
Certificate Expiration Date 11/3/2026
Facility Type Home Health Agency
Lab Director JEN CEBALLOS

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