10D0645076 CLIA NUMBER - ST AUGUSTINE FL OPCO LLC THE LILAC AT BAYVIEW

Laboratory Demographics

  • CLIA Code: 10D0645076
  • Facility Name: ST AUGUSTINE FL OPCO LLC THE LILAC AT BAYVIEW
  • Facility Address: 161 MARINE STREET
    SAINT AUGUSTINE, FL
    ZIP 32084
  • Facility Phone: 904 829-3475
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: GWENDOLYN STRUNK-GAMEL
  • NPI Number: 1861548562
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D0645076
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ST AUGUSTINE FL OPCO LLC THE LILAC AT BAYVIEW
Street 161 MARINE STREET
City SAINT AUGUSTINE
State FL
ZIP 32084
Phone 904 829-3475
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 GWENDOLYN STRUNK-GAMEL

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