10D0701294 CLIA NUMBER - JACKSONVILLE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 10D0701294
  • Facility Name: JACKSONVILLE PEDIATRICS
  • Facility Address: 2606 PARK STREET
    JACKSONVILLE, FL
    ZIP 32204
  • Facility Phone: 904 388-4646
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RANDOLPH E. THORNTON
  • NPI Number: 1043346745
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D0701294
LAB Type Physician Office
Facility Name JACKSONVILLE PEDIATRICS
Street 2606 PARK STREET
City JACKSONVILLE
State FL
ZIP 32204
Phone 904 388-4646
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2024
Certificate Expiration Date 7/13/2026
Facility Type Physician Office
Lab Director RANDOLPH E. THORNTON

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