NPIMap

Organization Active NPI

Bernhardt Laboratories Inc

  • Clinical Medical Laboratory
  • Jacksonville, FL
National Provider Identifier
1417960626
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
800001509 Issued in FL
Legal business name
BERNHARDT LABORATORIES INC
Practice address
3728 Philips Hwy Ste 60
Jacksonville, FL 32207-6898
Phone
(904) 296-2333
Fax
(904) 296-8467
NPI assigned
Aug 15, 2006
Last updated
Apr 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dina Valladares
Title
Director, Credentialing & Pe
Phone
(561) 514-5822

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 800001509 FL Primary

Addresses

Primary practice location

3728 Philips Hwy Ste 60
Jacksonville, FL 32207-6898

Mailing address

1355 River Bend Dr
Dallas, TX 75247-4915
Phone (561) 514-5822

Other identifiers 1

IdentifierTypeStateIssuer
002263700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040730000718 FL Part B Supplier - Independent Clinical Laboratory 5799755278 Practice locations: Jacksonville, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0645099Bernhardt Laboratories3728 Philips Hwy Ste 60, Jacksonville, FL 32207ComplianceDec 7, 2027

National Provider Directory

National Provider Directory

Locations

3728 Philips Hwy
Ste 64
Jacksonville, FL 32207
Phone (904) 296-2333

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775520000000",
    "number": "1417960626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 RIVER BEND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474915",
            "telephone_number": "561-514-5822",
            "fax_number": "844-751-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3728 PHILIPS HWY STE 60",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322076898",
            "telephone_number": "904-296-2333",
            "fax_number": "904-296-8467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERNHARDT LABORATORIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A",
        "authorized_official_last_name": "VALLADARES",
        "authorized_official_first_name": "DINA",
        "authorized_official_title_or_position": "DIRECTOR, CREDENTIALING & PE",
        "authorized_official_telephone_number": "561-514-5822"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800001509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002263700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.