10D2142040 CLIA NUMBER - BAPTIST PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 10D2142040
  • Facility Name: BAPTIST PRIMARY CARE
  • Facility Address: 1660 PRUDENTIAL DR STE 310
    JACKSONVILLE, FL
    ZIP 32207
  • Facility Phone: 904 396-8656
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GARY GABOR
  • NPI Number: 1639351927
  • Taxonomy: 207RR0500X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2142040
LAB Type Physician Office
Facility Name BAPTIST PRIMARY CARE
Street 1660 PRUDENTIAL DR STE 310
City JACKSONVILLE
State FL
ZIP 32207
Phone 904 396-8656
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/2/2024
Certificate Expiration Date 1/1/2026
Facility Type Physician Office
Lab Director GARY GABOR

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