10D2327236 CLIA NUMBER - ST AUGUSTINE DIRECT PRIMARY CARE LLC

Laboratory Demographics

  • CLIA Code: 10D2327236
  • Facility Name: ST AUGUSTINE DIRECT PRIMARY CARE LLC
  • Facility Address: 2200 N PONCE DE LEON BLVD SUITE1
    SAINT AUGUSTINE, FL
    ZIP 32084
  • Facility Phone: 904 962-7815
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARGARET E. CORRIGAN
  • NPI Number: 1417611369
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2327236
LAB Type Physician Office
Facility Name ST AUGUSTINE DIRECT PRIMARY CARE LLC
Street 2200 N PONCE DE LEON BLVD SUITE1
City SAINT AUGUSTINE
State FL
ZIP 32084
Phone 904 962-7815
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2025
Certificate Expiration Date 7/17/2027
Facility Type Physician Office
Lab Director MARGARET E. CORRIGAN

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