10D2307078 CLIA NUMBER - BAPTIST SOUTH SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D2307078
  • Facility Name: BAPTIST SOUTH SURGERY CENTER LLC
  • Facility Address: 14540 OLD ST AUGUSTINE ROAD, MEDICAL OFFICE BLDG 2
    JACKSONVILLE, FL
    ZIP 32258
  • Facility Phone: (260) 444-9543
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ANDREW A. STEC
  • NPI Number: 1952017832
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2307078
LAB Type Ambulatory Surgery Center
Facility Name BAPTIST SOUTH SURGERY CENTER LLC
Street 14540 OLD ST AUGUSTINE ROAD, MEDICAL OFFICE BLDG 2
City JACKSONVILLE
State FL
ZIP 32258
Phone 2604449543
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2026
Certificate Expiration Date 6/30/2028
Facility Type Ambulatory Surgery Center
Lab Director ANDREW A. STEC

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This page was last updated on: 6/29/2026