10D0645074 CLIA NUMBER - LIFE CARE PONTE VEDRA INC DBA VICAR'S LANDING NURSING HOME

Laboratory Demographics

  • CLIA Code: 10D0645074
  • Facility Name: LIFE CARE PONTE VEDRA INC DBA VICAR'S LANDING NURSING HOME
  • Facility Address: 1003 YORK ROAD
    PONTE VEDRA BEACH, FL
    ZIP 32082
  • Facility Phone: 904 285-1055
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BRUCE JONES
  • NPI Number: 1417044579
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D0645074
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LIFE CARE PONTE VEDRA INC DBA VICAR'S LANDING NURSING HOME
Street 1003 YORK ROAD
City PONTE VEDRA BEACH
State FL
ZIP 32082
Phone 904 285-1055
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 Skilled Nursing Facility/Nursing Facility
Lab Director BRUCE JONES

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