08D2121177 CLIA NUMBER - BELLEVUE HEART GROUP

Laboratory Demographics

CLIA Number: 08D2121177

Facility Name: BELLEVUE HEART GROUP

Facility Address:
1508 PENNSYLVANIA AVENUE, SUITE 2A
WILMINGTON, DE
ZIP 19806
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Facility Phone Number: 302 468-4500

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1972906766

Taxonomy: 207RC0000X - Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

CLIA Record

Field Name	Field Value
CLIA Number	08D2121177
LAB Type	Physician Office
Facility Name	BELLEVUE HEART GROUP
Street	1508 PENNSYLVANIA AVENUE, SUITE 2A
City	WILMINGTON
State	DE
ZIP	19806
Phone	302 468-4500
CertificateType	4
CertificateEffectiveDate	11/1/2022
CertificateExpirationDate	10/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024