10D0680660 CLIA NUMBER - JEREMY CAUDILL, DO LLC

Laboratory Demographics

  • CLIA Code: 10D0680660
  • Facility Name: JEREMY CAUDILL, DO LLC
  • Facility Address: 2460 OLD MOULTRIE ROAD SUITE 3
    SAINT AUGUSTINE, FL
    ZIP 32086
  • Facility Phone: 904 797-6627
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEREMY CAUDILL
  • NPI Number: 1265650295
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 10D0680660
LAB Type Physician Office
Facility Name JEREMY CAUDILL, DO LLC
Street 2460 OLD MOULTRIE ROAD SUITE 3
City SAINT AUGUSTINE
State FL
ZIP 32086
Phone 904 797-6627
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director JEREMY CAUDILL

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