10D2120381 CLIA NUMBER - PEACE RIVER CENTER LAKELAND CRISIS STABILIZATION UNIT

Laboratory Demographics

  • CLIA Code: 10D2120381
  • Facility Name: PEACE RIVER CENTER LAKELAND CRISIS STABILIZATION UNIT
  • Facility Address: 715 N LAKE AVE
    LAKELAND, FL
    ZIP 33801
  • Facility Phone: 863 519-0575
  • Facility Type: Other - MENTAL HEALTHCARE FACILIT
  • Facility Type: Waiver
  • Lab Director: MIGNON P. BURR
  • NPI Number: 1174279582
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 10D2120381
LAB Type Other - MENTAL HEALTHCARE FACILIT
Facility Name PEACE RIVER CENTER LAKELAND CRISIS STABILIZATION UNIT
Street 715 N LAKE AVE
City LAKELAND
State FL
ZIP 33801
Phone 863 519-0575
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2024
Certificate Expiration Date 10/16/2026
Facility Type Other - MENTAL HEALTHCARE FACILIT
Lab Director MIGNON P. BURR

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