10D0903603 CLIA NUMBER - BAPTIST PRIMARY CARE PONTE VEDRA

Laboratory Demographics

  • CLIA Code: 10D0903603
  • Facility Name: BAPTIST PRIMARY CARE PONTE VEDRA
  • Facility Address: 520 A1A N STE 101
    PONTE VEDRA BEACH, FL
    ZIP 32082
  • Facility Phone: 904 376-3742
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RONALD J. RENUART DO
  • NPI Number: 1902087836
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0903603
LAB Type Physician Office
Facility Name BAPTIST PRIMARY CARE PONTE VEDRA
Street 520 A1A N STE 101
City PONTE VEDRA BEACH
State FL
ZIP 32082
Phone 904 376-3742
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Physician Office
Lab Director RONALD J. RENUART DO

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