10D1031520 CLIA NUMBER - ADVANCED INTERVENTIONAL CARDIOLOGY CONSULTANTS

Laboratory Demographics

  • CLIA Code: 10D1031520
  • Facility Name: ADVANCED INTERVENTIONAL CARDIOLOGY CONSULTANTS
  • Facility Address: 320 SR 60 E
    LAKE WALES, FL
    ZIP 33853
  • Facility Phone: 863 679-7985
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BORIS D. NUNEZ
  • NPI Number: 1255310132
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1031520
LAB Type Physician Office
Facility Name ADVANCED INTERVENTIONAL CARDIOLOGY CONSULTANTS
Street 320 SR 60 E
City LAKE WALES
State FL
ZIP 33853
Phone 863 679-7985
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2024
Certificate Expiration Date 10/3/2026
Facility Type Physician Office
Lab Director BORIS D. NUNEZ

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