10D1033487 CLIA NUMBER - BAPTIST PRIMARY CARE INC

Laboratory Demographics

  • CLIA Code: 10D1033487
  • Facility Name: BAPTIST PRIMARY CARE INC
  • Facility Address: 4530 ST JOHNS AVE STE 13
    JACKSONVILLE, FL
    ZIP 32210
  • Facility Phone: 904 384-5222
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KRISTIE DRIVER
  • NPI Number: 1316128259
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1033487
LAB Type Physician Office
Facility Name BAPTIST PRIMARY CARE INC
Street 4530 ST JOHNS AVE STE 13
City JACKSONVILLE
State FL
ZIP 32210
Phone 904 384-5222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Physician Office
Lab Director KRISTIE DRIVER

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