10D2031861 CLIA NUMBER - FIRST COAST HEART AND VASCULAR CENTER PA

Laboratory Demographics

  • CLIA Code: 10D2031861
  • Facility Name: FIRST COAST HEART AND VASCULAR CENTER PA
  • Facility Address: 14 OFFICE PARK DR STE 1
    PALM COAST, FL
    ZIP 32137
  • Facility Phone: 386 446-9966
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VINCENT M. CARACCIOLO
  • NPI Number: 1861821084
  • Taxonomy: 103K00000X - Behavior Analyst

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CLIA Record

Field Name Field Value
CLIA Number 10D2031861
LAB Type Physician Office
Facility Name FIRST COAST HEART AND VASCULAR CENTER PA
Street 14 OFFICE PARK DR STE 1
City PALM COAST
State FL
ZIP 32137
Phone 386 446-9966
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Physician Office
Lab Director VINCENT M. CARACCIOLO

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