10D0266869 CLIA NUMBER - BAPTIST PRIMARY CARE INC

Laboratory Demographics

  • CLIA Code: 10D0266869
  • Facility Name: BAPTIST PRIMARY CARE INC
  • Facility Address: 1348 SOUTH 18TH STREET MOB, SUITE 100,
    FERNANDINA BEACH, FL
    ZIP 32034
  • Facility Phone: 904 261-0922
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DO KYLE REZAC
  • NPI Number: 1679881536
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0266869
LAB Type Physician Office
Facility Name BAPTIST PRIMARY CARE INC
Street 1348 SOUTH 18TH STREET MOB, SUITE 100,
City FERNANDINA BEACH
State FL
ZIP 32034
Phone 904 261-0922
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type Physician Office
Lab Director DO KYLE REZAC

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