10D0939044 CLIA NUMBER - PORT CHARLOTTE LIVING CENTER

Laboratory Demographics

  • CLIA Code: 10D0939044
  • Facility Name: PORT CHARLOTTE LIVING CENTER
  • Facility Address: 18480 COCHRAN BLVD
    PORT CHARLOTTE, FL
    ZIP 33948
  • Facility Phone: 941 743-4700
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: WOODIE W. LEE JR
  • NPI Number: 1043233992
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D0939044
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PORT CHARLOTTE LIVING CENTER
Street 18480 COCHRAN BLVD
City PORT CHARLOTTE
State FL
ZIP 33948
Phone 941 743-4700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2024
Certificate Expiration Date 1/19/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director WOODIE W. LEE JR

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