SOUTH LAKE HOSPITAL INC
NPI 1124418975
Skilled Nursing Facility in Clermont, FL

Active since February 02, 2015CLIA Certified · 4 labs
2145 DON WICKHAM DR, CLERMONT, FL 34711(352) 536-8787(352) 241-7124 Get Directions Write a Review

NPPES record last updated: June 5, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About South Lake Hospital Inc NPPES

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

SOUTH LAKE HOSPITAL INC (NPI 1124418975) is a healthcare organization registered as a skilled nursing facility in Clermont, Florida and active in the NPI registry since February 2015. The organization holds 4 active CLIA laboratory certificates and lists Lance Sewell, Cfo, as its authorized official.

NPPES Registry Identity

NPI1124418975
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameSOUTH LAKE HOSPITAL INC
Location Address2145 DON WICKHAM DRClermont, FL 34711
Mailing Address1900 Don Wickham DrClermont, FL 34711-1979 · (352) 394-4071 · Fax (352) 241-7124
Fax(352) 241-7124
Organization SubpartNo
Authorized OfficialLance SewellCfo · (352) 394-4071
Enumeration DateFebruary 2, 2015
Last NPPES UpdateJune 5, 2018
NPI 1124418975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in FL · 4180
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
2145 DON WICKHAM DR, Clermont, FL 34711

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA 4

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 Accreditation 10D0645240

South Lake Hospital Clinical Lab · Clermont, FL
Active · expires Jan 2, 2027
CLIA Number10D0645240
Laboratory TypeHospital
Certificate Effective DateJanuary 3, 2025
Certificate Expiration DateJanuary 2, 2027
Laboratory DirectorDr. Dana Razzano
Laboratory Phone(352) 241-7150
Laboratory LocationSouth Lake Hospital Clinical Lab1900 Don Wickham Drive, Clermont, FL 34711
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 10D2059559

South Lake Hospital Wound Care Center · Clermont, FL
Active · expires May 23, 2027
CLIA Number10D2059559
Laboratory TypeWound Care Center
Certificate Effective DateMay 24, 2025
Certificate Expiration DateMay 23, 2027
Laboratory DirectorPatrick G. Fairchild
Laboratory Phone(352) 394-4071
Laboratory LocationSouth Lake Hospital Wound Care Center2040 Oakley Seaver Dr, Clermont, FL 34711
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D1024525

South Lake Hospital Surgery Center · Clermont, FL
Active · expires Apr 13, 2028
CLIA Number10D1024525
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateApril 14, 2026
Certificate Expiration DateApril 13, 2028
Laboratory DirectorMs. Linda Reineke
Laboratory Phone(352) 241-7150
Laboratory LocationSouth Lake Hospital Surgery Center1800 Oakley Seaver Dr, Clermont, FL 34711
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 10D2145019

South Lake Hospital Joe H And Loretta Scott Medical Paviilion · Clermont, FL
Active · expires Apr 2, 2027
CLIA Number10D2145019
Laboratory TypeHospital
Certificate Effective DateApril 3, 2025
Certificate Expiration DateApril 2, 2027
Laboratory DirectorDr. Clifford H. Threlkeld
Laboratory Phone(352) 241-7209
Laboratory LocationSouth Lake Hospital Joe H And Loretta Scott Medical Paviilion16966 Cagan Ridge Blvd, Clermont, FL 34711
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

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 South Lake Hospital Inc's NPI number?

The NPI number for South Lake Hospital Inc is 1124418975. It was assigned to this organization in the NPPES registry on February 2, 2015.

Where is South Lake Hospital Inc located?

South Lake Hospital Inc is located at 2145 Don Wickham Dr, Clermont, FL 34711. The listed phone number is (352) 536-8787.

What is South Lake Hospital Inc's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does South Lake Hospital Inc hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does South Lake Hospital Inc accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Molina Healthcare list South Lake Hospital Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for South Lake Hospital Inc was last updated on June 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.