10D2269276 CLIA NUMBER - PEACE RIVER CENTER FOR PERSONAL DEVELOPMENT, INC

Laboratory Demographics

  • CLIA Code: 10D2269276
  • Facility Name: PEACE RIVER CENTER FOR PERSONAL DEVELOPMENT, INC
  • Facility Address: 1664 WILLIAMSBURG SQUARE
    LAKELAND, FL
    ZIP 33803
  • Facility Phone: 863 519-0575
  • Facility Type: Other - MENTAL HEALTH CLINIC
  • Facility Type: Waiver
  • Lab Director: TIFFANI B. FRITZSCHE
  • NPI Number: 1821097767
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2269276
LAB Type Other - MENTAL HEALTH CLINIC
Facility Name PEACE RIVER CENTER FOR PERSONAL DEVELOPMENT, INC
Street 1664 WILLIAMSBURG SQUARE
City LAKELAND
State FL
ZIP 33803
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 9/23/2024
Certificate Expiration Date 9/22/2026
Facility Type Other - MENTAL HEALTH CLINIC
Lab Director TIFFANI B. FRITZSCHE

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