10D2141260 CLIA NUMBER - PEACE RIVER CARDIOVASCULAR CENTER

Laboratory Demographics

  • CLIA Code: 10D2141260
  • Facility Name: PEACE RIVER CARDIOVASCULAR CENTER
  • Facility Address: 4161 TAMIAMI TRAIL STE 701
    PORT CHARLOTTE, FL
    ZIP 33952
  • Facility Phone: 941 629-5356
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID A. HOTCHKISS
  • NPI Number: 1326553793
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2141260
LAB Type Physician Office
Facility Name PEACE RIVER CARDIOVASCULAR CENTER
Street 4161 TAMIAMI TRAIL STE 701
City PORT CHARLOTTE
State FL
ZIP 33952
Phone 941 629-5356
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2023
Certificate Expiration Date 12/10/2025
Facility Type Physician Office
Lab Director DAVID A. HOTCHKISS

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