10D1037279 CLIA NUMBER - BAPTIST PRIMARY CARE, INC

Laboratory Demographics

  • CLIA Code: 10D1037279
  • Facility Name: BAPTIST PRIMARY CARE, INC
  • Facility Address: 1310 COUNTY ROAD 210 W
    ST JOHNS, FL
    ZIP 32259
  • Facility Phone: 904 824-4407
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW DEBOER
  • NPI Number: 1629250915
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1037279
LAB Type Physician Office
Facility Name BAPTIST PRIMARY CARE, INC
Street 1310 COUNTY ROAD 210 W
City ST JOHNS
State FL
ZIP 32259
Phone 904 824-4407
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2024
Certificate Expiration Date 4/13/2026
Facility Type Physician Office
Lab Director MATTHEW DEBOER

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