10D2092839 CLIA NUMBER - FIRST COAST HEART AND VASCULAR CENTER CATH LAB

Laboratory Demographics

  • CLIA Code: 10D2092839
  • Facility Name: FIRST COAST HEART AND VASCULAR CENTER CATH LAB
  • Facility Address: 14810 OLD ST AUGUSTINE RD STE 210
    JACKSONVILLE, FL
    ZIP 32258
  • Facility Phone: 904 423-1850
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. LARRY V. CRISCO
  • NPI Number: 1245815430
  • Taxonomy: 213E00000X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 10D2092839
LAB Type Physician Office
Facility Name FIRST COAST HEART AND VASCULAR CENTER CATH LAB
Street 14810 OLD ST AUGUSTINE RD STE 210
City JACKSONVILLE
State FL
ZIP 32258
Phone 904 423-1850
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 9/2/2025
Certificate Expiration Date 9/1/2027
Facility Type Physician Office
Lab Director DR. LARRY V. CRISCO

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