NPI 1629604046

Ancient City Diagnostics, LLC

Organisation Military Clinical Medical Laboratory Saint Augustine, FL

Practice location

Address: 150 Southpark Blvd STE 206, Saint Augustine, FL 32086-5179
Phone: (904) 439-3414
Mailing address: 8563 Argyle Business Loop STE 5, Jacksonville, FL 32244-6613

Authorised official

Name: Christopher Edmondson
Title: Owner
Phone: (904) 439-3414

Registered specialties

Military Clinical Medical Laboratory Primary

Laboratories Taxonomy 291900000X

Other Military Clinical Medical Laboratory providers in Florida →

Registry record

NPI: 1629604046
Entity type: Organization
NPI issued: 17 Mar 2020
Record last updated: 17 Mar 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.