10D2092035 CLIA NUMBER - BAPTIST PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 10D2092035
  • Facility Name: BAPTIST PRIMARY CARE
  • Facility Address: 400 COLONNADE DRIVE SUITE 160
    PONTE VEDRA, FL
    ZIP 32081
  • Facility Phone: 904 824-1020
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSHUA HARRISON
  • NPI Number: 1538566542
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2092035
LAB Type Physician Office
Facility Name BAPTIST PRIMARY CARE
Street 400 COLONNADE DRIVE SUITE 160
City PONTE VEDRA
State FL
ZIP 32081
Phone 904 824-1020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/25/2025
Certificate Expiration Date 2/24/2027
Facility Type Physician Office
Lab Director JOSHUA HARRISON

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