10D2166935 CLIA NUMBER - BAPTIST PRIMARY CARE INC

Laboratory Demographics

  • CLIA Code: 10D2166935
  • Facility Name: BAPTIST PRIMARY CARE INC
  • Facility Address: 4844 DEER LAKE DR WEST SUITE 1
    JACKSONVILLE, FL
    ZIP 32246
  • Facility Phone: 904 738-8690
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAUREN PROSTROLLO DO
  • NPI Number: 1093122715
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2166935
LAB Type Physician Office
Facility Name BAPTIST PRIMARY CARE INC
Street 4844 DEER LAKE DR WEST SUITE 1
City JACKSONVILLE
State FL
ZIP 32246
Phone 904 738-8690
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2025
Certificate Expiration Date 5/29/2027
Facility Type Physician Office
Lab Director LAUREN PROSTROLLO DO

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