10D0945453 CLIA NUMBER - ANDREW J RANDOLPH MD PA

Laboratory Demographics

  • CLIA Code: 10D0945453
  • Facility Name: ANDREW J RANDOLPH MD PA
  • Facility Address: 1025 N STONE STREET
    DELAND, FL
    ZIP 32720
  • Facility Phone: 904 734-4453
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANDREW J. RANDOLPH
  • NPI Number: 1821304429
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0945453
LAB Type Physician Office
Facility Name ANDREW J RANDOLPH MD PA
Street 1025 N STONE STREET
City DELAND
State FL
ZIP 32720
Phone 904 734-4453
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2024
Certificate Expiration Date 5/3/2026
Facility Type Physician Office
Lab Director ANDREW J. RANDOLPH

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