10D0266869 CLIA NUMBER - BAPTIST PRIMARY CARE INC

Laboratory Demographics

CLIA Number: 10D0266869

Facility Name: BAPTIST PRIMARY CARE INC

Facility Address:
1888 S 14TH ST
FERNANDINA BEACH, FL
ZIP 32034
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Facility Phone Number: 904 261-0922

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1679881536

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D0266869
LAB Type	Physician Office
Facility Name	BAPTIST PRIMARY CARE INC
Street	1888 S 14TH ST
City	FERNANDINA BEACH
State	FL
ZIP	32034
Phone	904 261-0922
CertificateType	4
CertificateEffectiveDate	11/19/2023
CertificateExpirationDate	11/18/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024