Provider Demographics
NPI:1063482156
Name:CARDIOLABS, INC.
Entity type:Organization
Organization Name:CARDIOLABS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAAG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-304-1098
Mailing Address - Street 1:100 S MULBERRY ST STE 101
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-5023
Mailing Address - Country:US
Mailing Address - Phone:800-304-1098
Mailing Address - Fax:
Practice Address - Street 1:100 S MULBERRY ST STE 101
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-5023
Practice Address - Country:US
Practice Address - Phone:800-304-1098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes293D00000XLaboratoriesPhysiological Laboratory
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA127935OtherSOUTHERN HEALTH
MO7817OtherCOVENTRY HEALTHCARE OF KS
TN3010968OtherBCBS OF TN
VA194843OtherANTHEM BCBS OF VA
P00093878OtherRAILROAD MEDICARE
KS200263800AMedicaid
TN3791095Medicaid
VA010157188Medicaid
MO043260OtherFAMILY HEALTH PARTNERS
KS146796OtherUNICARE OF KS
PA314335OtherHIGHMARK BCBS OF PA
MO718741408Medicaid
VA98397OtherOPTIMA SENTARA
TN01063104OtherAMERIGROUP
TN060A117OtherHEALTHSPRING
P00093878OtherRAILROAD MEDICARE