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COASTAL COMMUNITY HEALTH SERVICES, INC.
NPI 1851131874
Clinic/Center - Federally Qualified Health Center (FQHC) in Fernandina Beach, FL

Active since May 28, 2024CLIA 10D2309865 · Microscopy
22385 FLORA PARK CROSSING DRIVE, FERNANDINA BEACH, FL 32034(904) 404-8641(904) 227-3246 Get Directions Write a Review

NPPES record last updated: May 28, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Coastal Community Health Services, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COASTAL COMMUNITY HEALTH SERVICES, INC. (NPI 1851131874) is a healthcare organization registered as a federally qualified health center (fqhc) in Fernandina Beach, Florida and active in the NPI registry since May 2024. The organization holds a CLIA Microscopy certificate valid through August 21, 2026 and lists Kavanaugh Chandler, Ceo, as its authorized official.

NPPES Registry Identity

NPI1851131874
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameCOASTAL COMMUNITY HEALTH SERVICES, INC.
Location Address22385 FLORA PARK CROSSING DRIVEFernandina Beach, FL 32034
Mailing Address100 Professional Center DrBrunswick, GA 31525-6743 · (912) 574-5075
Phone(904) 404-8641
Fax(904) 227-3246
Organization SubpartNo
Authorized OfficialKavanaugh ChandlerCeo · (912) 275-8028
Enumeration DateMay 28, 2024
NPPES CertifiedMay 22, 2024
✔ NPI 1851131874 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
22385 FLORA PARK CROSSING DRIVE, Fernandina Beach, FL 32034
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 10D2309865

Coastal Community Health Services Inc · Fernandina Beach, FL
Active · expires Aug 21, 2026
CLIA Number10D2309865
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateAugust 22, 2024
Certificate Expiration DateAugust 21, 2026
Laboratory DirectorDennis Horner
Laboratory Phone(912) 574-5076
Laboratory LocationCoastal Community Health Services Inc22385 Flora Park Crossing Dr, Fernandina Beach, FL 32034
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions

What is COASTAL COMMUNITY HEALTH SERVICES, INC.'s NPI number?

The NPI number assigned to this healthcare provider is 1851131874, enumerated as an "organization" on May 28, 2024.

Where is the provider located?

The provider is located at 22385 FLORA PARK CROSSING DRIVE FERNANDINA BEACH, FL 32034 and the phone number is (904) 404-8641.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).