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10D2272281 CLIA NUMBER - BAPTIST AGEWELL PHYSICIANS, INC

Laboratory Demographics

CLIA Number: 10D2272281

Facility Name: BAPTIST AGEWELL PHYSICIANS, INC

Facility Address:
700 3RD ST - STE 102
NEPTUNE BEACH, FL
ZIP 32266
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Facility Phone Number: 904 202-4243

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1124788146

Taxonomy: 207QG0300X - Family Medicine
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

CLIA Record

Field Name Field Value
CLIA Number 10D2272281
LAB Type Physician Office
Facility Name BAPTIST AGEWELL PHYSICIANS, INC
Street 700 3RD ST - STE 102
City NEPTUNE BEACH
State FL
ZIP 32266
Phone 904 202-4243
CertificateType 4
CertificateEffectiveDate 11/17/2022
CertificateExpirationDate 11/16/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024