10D1097434 CLIA NUMBER - BAPTIST PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 10D1097434
  • Facility Name: BAPTIST PRIMARY CARE
  • Facility Address: 141 HILDEN RD STE 201
    PONTE VEDRA, FL
    ZIP 32081
  • Facility Phone: 904 825-1941
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELICIA D. ROOS
  • NPI Number: 1659513539
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1097434
LAB Type Physician Office
Facility Name BAPTIST PRIMARY CARE
Street 141 HILDEN RD STE 201
City PONTE VEDRA
State FL
ZIP 32081
Phone 904 825-1941
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Physician Office
Lab Director ELICIA D. ROOS

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This page was last updated on: 6/4/2025