CLIA lab

CLIA 10D0269206: C W Randolph JR MD PA

Jacksonville Beach, FL. Certificate and address details from the CMS Provider of Services file for clinical laboratories.

CLIA number 10D0269206 belongs to C W Randolph JR MD PA in Jacksonville Beach, FL.

Certificate of Waiver, effective July 13, 2026, expires July 12, 2028.

Active in the CMS Provider of Services file posted October 16, 2026.

Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page

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Certificate

Certificate type
Certificate of Waiver
Certificate effective
July 13, 2026
Certificate expiration
July 12, 2028
Status in the CMS file
Active (termination code 00)
Original participation date
February 9, 1993
Facility type
Physician office
Ownership (control type)
Proprietary
Lab classification
CLIA laboratory

Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page

Lab and contact

CLIA number
10D0269206
Lab name
C W Randolph JR MD PA
Address
1891 Beach Blvd Suite 200, Jacksonville Beach, FL 32250
Phone
(904) 249-3743

Annual test volume the lab reported

Waived tests
1,500

Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.

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Related

Questions

What is the CLIA number for C W Randolph JR MD PA in Jacksonville Beach?

10D0269206, per the CMS Provider of Services file posted October 16, 2026.

What CLIA certificate does C W Randolph JR MD PA hold?

A Certificate of Waiver, according to the CMS file.

When does CLIA 10D0269206 expire?

The CMS file lists July 12, 2028 as the certificate expiration date; the certificate took effect July 13, 2026.

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