10D2125570 CLIA NUMBER - BAPTIST PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 10D2125570
  • Facility Name: BAPTIST PRIMARY CARE
  • Facility Address: 1029 ATLANTIC BOULEVARD
    ATLANTIC BEACH, FL
    ZIP 32233
  • Facility Phone: 904 246-7520
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW MODANSKY
  • NPI Number: 1396415212
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2125570
LAB Type Physician Office
Facility Name BAPTIST PRIMARY CARE
Street 1029 ATLANTIC BOULEVARD
City ATLANTIC BEACH
State FL
ZIP 32233
Phone 904 246-7520
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2025
Certificate Expiration Date 2/8/2027
Facility Type Physician Office
Lab Director MATTHEW MODANSKY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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