10D2322668 CLIA NUMBER - BAPTIST AGEWELL PHYSICIANS INC

Laboratory Demographics

  • CLIA Code: 10D2322668
  • Facility Name: BAPTIST AGEWELL PHYSICIANS INC
  • Facility Address: 1545 SOUTH 14TH AVE
    FERNANDINA BEACH, FL
    ZIP 32034
  • Facility Phone: 904 202-4600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALISON BARTFIELD
  • NPI Number: 1710464946
  • Taxonomy: 207RG0300X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2322668
LAB Type Physician Office
Facility Name BAPTIST AGEWELL PHYSICIANS INC
Street 1545 SOUTH 14TH AVE
City FERNANDINA BEACH
State FL
ZIP 32034
Phone 904 202-4600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/24/2025
Certificate Expiration Date 4/23/2027
Facility Type Physician Office
Lab Director ALISON BARTFIELD

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