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Organization
ANCIENT CITY DIAGNOSTICS, LLC
Active
Organization
ANCIENT CITY DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER EDMONDSON (OWNER)
(904) 439-3414
Entity
Organization
Contact information
Practice address
150 SOUTHPARK BLVD STE 206, SAINT AUGUSTINE, FL 32086-5179
(904) 439-3414
Mailing address
8563 ARGYLE BUSINESS LOOP STE 5, JACKSONVILLE, FL 32244-6613
(904) 439-3414
Taxonomy
Speciality
Code
Description
License number
State
291900000X
Military Clinical Medical Laboratory
Primary
—
NULL
Other
Enumeration date
03/17/2020
Last updated
03/17/2020
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