10D2057080 CLIA NUMBER - BAPTIST CARDIOLOGY INC DBA BAPTIST HEART SPECIALISTS

Laboratory Demographics

  • CLIA Code: 10D2057080
  • Facility Name: BAPTIST CARDIOLOGY INC DBA BAPTIST HEART SPECIALISTS
  • Facility Address: 2310 VILLAGE SQUARE PARKWAY, SUITE 204
    FLEMING ISLAND, FL
    ZIP 32003
  • Facility Phone: 904 224-5185
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHETAN V. HAMPOLE
  • NPI Number: 1629416805
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2057080
LAB Type Physician Office
Facility Name BAPTIST CARDIOLOGY INC DBA BAPTIST HEART SPECIALISTS
Street 2310 VILLAGE SQUARE PARKWAY, SUITE 204
City FLEMING ISLAND
State FL
ZIP 32003
Phone 904 224-5185
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/9/2025
Certificate Expiration Date 4/8/2027
Facility Type Physician Office
Lab Director CHETAN V. HAMPOLE

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