10D0977150 CLIA NUMBER - BAPTIST PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 10D0977150
  • Facility Name: BAPTIST PRIMARY CARE
  • Facility Address: 2310 VILLAGE SQUARE PKWY - STE 201
    FLEMING ISLAND, FL
    ZIP 32003
  • Facility Phone: 904 264-6404
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PETER JANSEN
  • NPI Number: 1457791246
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D0977150
LAB Type Physician Office
Facility Name BAPTIST PRIMARY CARE
Street 2310 VILLAGE SQUARE PKWY - STE 201
City FLEMING ISLAND
State FL
ZIP 32003
Phone 904 264-6404
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2024
Certificate Expiration Date 8/21/2026
Facility Type Physician Office
Lab Director PETER JANSEN

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