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MIRRAH IMAGE SERVICES LLC
NPI 1104449784
In Home Supportive Care in Leesburg, FL

Active since May 18, 2020CLIA 10D2277062 · Waiver
2862 W MAIN ST, LEESBURG, FL 34748(407) 813-2112 Get Directions Write a Review

NPPES record last updated: March 17, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 17, 2026, May 18, 2020 (2 updates tracked since 2020).

About Mirrah Image Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIRRAH IMAGE SERVICES LLC (NPI 1104449784) is a healthcare organization registered as an in home supportive care in Leesburg, Florida and active in the NPI registry since May 2020. The organization holds a CLIA Waiver certificate valid through February 20, 2027 and lists Jennifer Dickens, Owner, as its authorized official.

NPPES Registry Identity

NPI1104449784
Entity TypeOrganization
Primary Taxonomy253Z00000X
Legal Business NameMIRRAH IMAGE SERVICES LLC
Location Address2862 W MAIN STLeesburg, FL 34748-4631
Mailing Address2862 W Main StLeesburg, FL 34748-4631 · (407) 813-2112
Phone(407) 813-2112
Organization SubpartNo
Authorized OfficialJennifer DickensOwner · (407) 421-7324
Enumeration DateMay 18, 2020
Last NPPES UpdateMarch 17, 20262 updates tracked since enumeration
NPPES CertifiedMarch 17, 2026
✔ NPI 1104449784 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyIn Home Supportive CareAgencies
Taxonomy Code253Z00000X
Definition
An In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves.
Also ListedDay Training, Developmentally Disabled ServicesTaxonomy 251C00000X
Also ListedHome HealthTaxonomy 251E00000X
Also ListedRespite Care · Respite Care, Intellectual and/or Developmental DisabilitiesTaxonomy 385HR2060X
2862 W MAIN ST, Leesburg, FL 34748
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2277062

Mirrah Image Services LLC · Clermont, FL
Active · expires Feb 20, 2027
CLIA Number10D2277062
Laboratory TypeHome Health Agency
Certificate Effective DateFebruary 21, 2025
Certificate Expiration DateFebruary 20, 2027
Laboratory DirectorJennifer Dickens
Laboratory Phone(407) 813-2112
Laboratory LocationMirrah Image Services LLC2345 Golden Aster St, Clermont, FL 34711
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISTY C ALLEN CRNA
Nurse Anesthetist, Certified Registered
2862 W MAIN ST
LEESBURG, FL 34748
Lake County (352) 326-4014

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mirrah Image Services LLC's NPI number?

The NPI number for Mirrah Image Services LLC is 1104449784. It was assigned to this organization in the NPPES registry on May 18, 2020.

Where is Mirrah Image Services LLC located?

Mirrah Image Services LLC is located at 2862 W Main St, Leesburg, FL 34748. The listed phone number is (407) 813-2112.

What is Mirrah Image Services LLC's specialty?

The primary specialty registered for this NPI is In Home Supportive Care with taxonomy code 253Z00000X.

Does Mirrah Image Services LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2277062) is associated with this NPI, valid through February 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mirrah Image Services LLC was last updated on March 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.