OrganizationActive
Ancient City Diagnostics, LLC
NPI 1629604046 · Military Clinical Medical Laboratory · Saint Augustine, FL
Provider details
- NPI number
- 1629604046
- Entity type
- Organization
- Primary specialty
- Military Clinical Medical LaboratoryLaboratories
- Authorized official
- Christopher Edmondson, Owner
Practice location
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
Registry dates
- Enumerated
- 2020-03-17
- Last updated
- 2020-03-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.