Organization
MAYO CLINIC JACKSONVILLE
Active
Other names
Mayo Clinic Independent Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE RIGDON (CHIEF FINANCIAL OFFICER)
(904) 953-0577
Entity
Organization
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-7355
(904) 953-1768
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-7355
(904) 953-1768
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
800001521
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L8533
MEDICARE PTAN
—
Enumeration date
09/30/2005
Last updated
04/15/2026
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