10D2325701 CLIA NUMBER - BAPTIST PRIMARY CARE INC

Laboratory Demographics

  • CLIA Code: 10D2325701
  • Facility Name: BAPTIST PRIMARY CARE INC
  • Facility Address: 400 COLONNADE DRIVE, SUITE 230 POD D1
    PONTE VEDRA, FL
    ZIP 32081
  • Facility Phone: 904 376-3970
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOEL AHLGRIM DO
  • NPI Number: 1609667930
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2325701
LAB Type Physician Office
Facility Name BAPTIST PRIMARY CARE INC
Street 400 COLONNADE DRIVE, SUITE 230 POD D1
City PONTE VEDRA
State FL
ZIP 32081
Phone 904 376-3970
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2025
Certificate Expiration Date 6/17/2027
Facility Type Physician Office
Lab Director JOEL AHLGRIM DO

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