10D2063011 CLIA NUMBER - CRESCENT BEACH CARE LLC

Laboratory Demographics

  • CLIA Code: 10D2063011
  • Facility Name: CRESCENT BEACH CARE LLC
  • Facility Address: 6573 AIA SOUTH
    SAINT AUGUSTINE, FL
    ZIP 32080
  • Facility Phone: 904 342-7363
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARGRET THORHALLSDOTTIR
  • NPI Number: 1033451380
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2063011
LAB Type Physician Office
Facility Name CRESCENT BEACH CARE LLC
Street 6573 AIA SOUTH
City SAINT AUGUSTINE
State FL
ZIP 32080
Phone 904 342-7363
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/25/2025
Certificate Expiration Date 7/24/2027
Facility Type Physician Office
Lab Director MARGRET THORHALLSDOTTIR

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