ST JOHNS BIOMEDICAL LABORATORIES INC (NPI# 1821001330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821001330 |
| Entity Type | Organization |
| Organization Name | ST JOHNS BIOMEDICAL LABORATORIES INC |
| Practice Address |
165 Southpark Blvd Suite A St Augustine FL 32086-4101 |
| Mailing Address |
Po Box 860206 165 Southpark Blvd St. Augustine FL 32086-0206 |
| Practice Telephone | 9048245497 |
| Practice Fax Number | 9048248257 |
| Mailing Telephone | 9048245497 |
| Mailing Fax Number | 9048248257 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2008-06-17 |
| Authorized Official Name | EDWIN OLIVA SIA (DIRECTOR/OWNER) |
| Authorized Official Telephone | 9048245497 |
| Authorized Official Credential | MD, BCLD(ABB) |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 800001722 | FL | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 030142600 | 05 | |
| FL | CLIA | 10D0645082 | 01 |
| FL | CLINICAL LAB LICENSE | 800001722 | 01 |
| Street Address |
165 SOUTHPARK BLVD SUITE A |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32086-4101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952352189 | Avanti Wellness Center Inc | Clinic/Center | 165 Southpark Blvd, Suite D, St Augustine, FL 32086-4101 | 2006-05-12 |
| 1891298790 | Fm Medical Clinic LLC | Clinic/Center | 165 Southpark Blvd, St Augustine, FL 32086-4101 | 2018-03-16 |
| 1750836086 | Kelli Mclaughlin | Nurse Practitioner | 165 Southpark Blvd, St Augustine, FL 32086-4101 | 2016-08-16 |
| 1053790246 | Fm Medical Urgent Care, Inc. | Clinic/Center | 165 Southpark Blvd, Suite C, St Augustine, FL 32086-4101 | 2015-05-21 |
| 1588091029 | Fm Medical LLC | Family Medicine | 165 Southpark Blvd, St Augustine, FL 32086-4101 | 2013-09-30 |
| 1053652099 | Fm Medical | Clinic/Center | 165 Southpark Blvd, Suite C & D, St Augustine, FL 32086-4101 | 2013-03-14 |
| 1750680591 | Marybeth Dyckes | Massage Therapist | 165 Southpark Blvd, Suite C and D, St Augustine, FL 32086-4101 | 2011-03-18 |
| 1043535412 | Juliana Joy Farrell | Chiropractor | 165 Southpark Blvd, Suite C and D, St Augustine, FL 32086-4101 | 2010-03-29 |
| 1285877092 | Denise J Nealey | Counselor | 165 Southpark Blvd, Suite C, St Augustine, FL 32086-4101 | 2009-04-08 |
| 1073755815 | Annette Zavro | Counselor | 165 Southpark Blvd, Suite D, St Augustine, FL 32086-4101 | 2009-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225670037 | Ramonica Flagler | Nurse Practitioner | 3574 Us-1 South, St. Augustine, FL 32086 | 2019-10-14 |
| 1518522648 | Marissa Marie Lynch | Physician Assistant | 100 Whetstone Pl Ste 102, St Augustine, FL 32086 | 2019-05-03 |
| 1346706991 | Castillo Transportation | Non-emergency Medical Transport (VAN) | 295 North Hidden Tree Dr, Saint Augustine, FL 32086 | 2019-02-19 |
| 1790255842 | Michelle Moore | In Home Supportive Care | 135 Jenkins St. Suite 105b #265, St.augustine, FL 32086 | 2018-12-03 |
| 1649740200 | Paul James Lietz IIi | Physical Therapist | One Orthopedic Place, Saint Augustine, FL 32086 | 2018-11-27 |
| 1548764707 | Oceanside Endodontics Od St. Augustine | Dentist | 2510 U.S. 1 South, Suite B, St. Augustine, FL 32086 | 2018-03-22 |
| 1023538329 | Joseph R Edwards | Physical Therapist | 968 Espinado Avenue, St Augustine, FL 32086 | 2017-06-27 |
| 1235662032 | Jennifer L Csenge | Dentist | 4327 Us Highway 1 S, St Augustine, FL 32086 | 2017-04-07 |
| 1336683663 | Lisa Brice | Social Worker | 248 Southpark Circle East, Saint Augustine, FL 32086 | 2016-12-06 |
| 1558813303 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 65 Whitehall Drive, Saint Augustine, FL 32086 | 2016-10-27 |
| Find all providers in zip 32086 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710358932 | Florida Laboratory Analysis, LLC | Clinical Medical Laboratory | 1690 Us Highway 1 S Ste D, St Augustine, FL 32084 | 2015-10-14 |
| 1700141439 | Advanced Medical Laboratories Inc | Clinical Medical Laboratory | 1690 Us Highway 1 South, Suite D, St Augustine, FL 32084-6024 | 2012-07-09 |
| 1093033003 | Avanti Wellness Center Flllp | Clinical Medical Laboratory | 3574 Us 1 S, Suite 113, St Augustine, FL 32086-6466 | 2010-05-14 |
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| 1346840485 | Millenia Advanced Scientific LLC | Clinical Medical Laboratory | 4303 Vineland Rd Ste F10, Orlando, FL 32811-7372 | 2020-10-28 |
| 1922607886 | Emed Labs LLC | Clinical Medical Laboratory | 990 Biscayne Blvd Ste 1501, Miami, FL 33132-1559 | 2020-10-21 |
| 1033718333 | Jmj Labs LLC Dba Arcpoint Labs of Saint Petersburg | Clinical Medical Laboratory | 4713 66th St N, Kenneth City, FL 33709-3113 | 2020-10-19 |
| 1134728405 | Biolabs Diagnostics LLC | Clinical Medical Laboratory | 7865 Sw Ellipse Way, Stuart, FL 34997-7247 | 2020-10-19 |
| 1013516319 | Axe Analytics, LLC | Clinical Medical Laboratory | 917 Se Lincoln Ave Ste B, Stuart, FL 34994-3810 | 2020-10-19 |
| 1497352082 | Medlab Diagnostics, LLC | Clinical Medical Laboratory | 1430 S Dixie Hwy Ste 320, Coral Gables, FL 33146-3175 | 2020-10-06 |
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| City | ST AUGUSTINE |
| Zip Code | 32086 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.