EXCELSIOR DIAGNOSTICS LLC
NPI 1093494627
Clinical Medical Laboratory in Jacksonville, FL

Active since July 12, 2023CLIA 10D2283166 · Waiver
12724 GRAN BAY PKWY W STE 410, JACKSONVILLE, FL 32258(904) 799-6520(904) 799-6588 Get Directions Write a Review

NPPES record last updated: September 5, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 5, 2025, Jul 12, 2023 (2 updates tracked since 2023).

About Excelsior Diagnostics Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EXCELSIOR DIAGNOSTICS LLC (NPI 1093494627) is a healthcare organization registered as a clinical medical laboratory in Jacksonville, Florida and active in the NPI registry since July 2023. The organization holds a CLIA Waiver certificate valid through June 1, 2027 and lists Whitney Whyte, Director, as its authorized official.

NPPES Registry Identity

NPI1093494627
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameEXCELSIOR DIAGNOSTICS LLC
Location Address12724 GRAN BAY PKWY W STE 410Jacksonville, FL 32258-9486
Mailing Address12724 Gran Bay Pkwy W Ste 410Jacksonville, FL 32258-9486 · (888) 742-6245
Fax(904) 799-6588
Organization SubpartNo
Authorized OfficialWhitney WhyteDirector · (888) 742-6245
Enumeration DateJuly 12, 2023
Last NPPES UpdateSeptember 5, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 5, 2025
NPI 1093494627 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
Definition

(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

Also ListedPhysiological LaboratoryTaxonomy 293D00000X
12724 GRAN BAY PKWY W STE 410, Jacksonville, FL 32258

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2283166

Excelsior Diagnostics LLC · Jacksonville, FL
Active · expires Jun 1, 2027
CLIA Number10D2283166
Laboratory TypeMobile Laboratory
Certificate Effective DateJune 2, 2025
Certificate Expiration DateJune 1, 2027
Laboratory DirectorWhitney Whyte
Laboratory Phone(904) 799-6520
Laboratory LocationExcelsior Diagnostics LLC12724 Gran Bay Pkwy W, Jacksonville, FL 32258
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Behavior Technician
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258
Behavior Technician
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258
Social Worker (Clinical)
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258
Behavior Technician
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258
Nurse Practitioner (Psychiatric/Mental Health)
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258
Behavior Technician
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258
Behavior Technician
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258
Behavior Technician
12724 GRAN BAY PKWY W STE 410
JACKSONVILLE, FL 32258

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Excelsior Diagnostics LLC's NPI number?

The NPI number for Excelsior Diagnostics LLC is 1093494627. It was assigned to this organization in the NPPES registry on July 12, 2023.

Where is Excelsior Diagnostics LLC located?

Excelsior Diagnostics LLC is located at 12724 Gran Bay Pkwy W Ste 410, Jacksonville, FL 32258. The listed phone number is (904) 799-6520.

What is Excelsior Diagnostics LLC's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Excelsior Diagnostics LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2283166) is associated with this NPI, valid through June 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Excelsior Diagnostics LLC was last updated on September 5, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.