10D0294575 CLIA NUMBER - HARBOR CARDIOLOGY & VASCULAR CTR PA

Laboratory Demographics

CLIA Number: 10D0294575

Facility Name: HARBOR CARDIOLOGY & VASCULAR CTR PA

Facility Address:
2400 HARBOR BLVD STE 12
PORT CHARLOTTE, FL
ZIP 33952
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Facility Phone Number: 813 625-6187

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1922189018

Taxonomy: 207RC0000X - Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

CLIA Record

Field Name	Field Value
CLIA Number	10D0294575
LAB Type	Physician Office
Facility Name	HARBOR CARDIOLOGY & VASCULAR CTR PA
Street	2400 HARBOR BLVD STE 12
City	PORT CHARLOTTE
State	FL
ZIP	33952
Phone	813 625-6187
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024