10D1002177 CLIA NUMBER - BAPTIST PRIMARY CARE INC

Laboratory Demographics

  • CLIA Code: 10D1002177
  • Facility Name: BAPTIST PRIMARY CARE INC
  • Facility Address: 30 ARDISIA LANE
    ST JOHNS, FL
    ZIP 32259
  • Facility Phone: 904 287-2794
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DONALD LEVINE
  • NPI Number: 1669653622
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1002177
LAB Type Physician Office
Facility Name BAPTIST PRIMARY CARE INC
Street 30 ARDISIA LANE
City ST JOHNS
State FL
ZIP 32259
Phone 904 287-2794
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Physician Office
Lab Director DONALD LEVINE

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