10D1044391 CLIA NUMBER - BAPTIST PRIMARY CARE, INC

Laboratory Demographics

  • CLIA Code: 10D1044391
  • Facility Name: BAPTIST PRIMARY CARE, INC
  • Facility Address: 230 VILLAGE COMMONS DR
    SAINT AUGUSTINE, FL
    ZIP 32092
  • Facility Phone: 904 940-1441
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HEATHER NIELSEN
  • NPI Number: 1861776403
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1044391
LAB Type Physician Office
Facility Name BAPTIST PRIMARY CARE, INC
Street 230 VILLAGE COMMONS DR
City SAINT AUGUSTINE
State FL
ZIP 32092
Phone 904 940-1441
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2025
Certificate Expiration Date 8/17/2027
Facility Type Physician Office
Lab Director HEATHER NIELSEN

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