10D1032877 CLIA NUMBER - PRIMECARE PL

Laboratory Demographics

  • CLIA Code: 10D1032877
  • Facility Name: PRIMECARE PL
  • Facility Address: 2720 US HWY 1 S STE B
    SAINT AUGUSTINE, FL
    ZIP 32086
  • Facility Phone: 904 827-0078
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PHILLIP A. WIMPELBERG
  • NPI Number: 1407038169
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1032877
LAB Type Physician Office
Facility Name PRIMECARE PL
Street 2720 US HWY 1 S STE B
City SAINT AUGUSTINE
State FL
ZIP 32086
Phone 904 827-0078
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2024
Certificate Expiration Date 10/31/2026
Facility Type Physician Office
Lab Director PHILLIP A. WIMPELBERG

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