10D1008195 CLIA NUMBER - FLORIDA KIDNEY PHYSICIANS, LLC

Laboratory Demographics

  • CLIA Code: 10D1008195
  • Facility Name: FLORIDA KIDNEY PHYSICIANS, LLC
  • Facility Address: 2852 TAMIAMI TRAIL - SUITES 1-4
    PORT CHARLOTTE, FL
    ZIP 33952
  • Facility Phone: 941 505-8720
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIANOOSH KAVEH
  • NPI Number: 1205409752
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1008195
LAB Type Physician Office
Facility Name FLORIDA KIDNEY PHYSICIANS, LLC
Street 2852 TAMIAMI TRAIL - SUITES 1-4
City PORT CHARLOTTE
State FL
ZIP 33952
Phone 941 505-8720
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2025
Certificate Expiration Date 1/13/2027
Facility Type Physician Office
Lab Director KIANOOSH KAVEH

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