10D0268307 CLIA NUMBER - BAPTIST PRIMARY CARE INC

Laboratory Demographics

  • CLIA Code: 10D0268307
  • Facility Name: BAPTIST PRIMARY CARE INC
  • Facility Address: 532 RIVERSIDE AVE - STE 103
    JACKSONVILLE, FL
    ZIP 32202
  • Facility Phone: 904 353-5696
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TRA CHELLA J. FOY
  • NPI Number: 1013160704
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0268307
LAB Type Physician Office
Facility Name BAPTIST PRIMARY CARE INC
Street 532 RIVERSIDE AVE - STE 103
City JACKSONVILLE
State FL
ZIP 32202
Phone 904 353-5696
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director TRA CHELLA J. FOY

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