PRINCETON CLINICAL LABS – NPI #1205770930
Technician, Pathology

An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405.

Health Care Provider Taxonomy Code for Technician, Pathology

PRINCETON CLINICAL LABS is a pathology technician located in JACKSONVILLE, FL. NPPES recently assigned the NPI number 1205770930 to PRINCETON CLINICAL LABS on April 15, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 247ZC0005X from the Health Care Provider Taxonomy code set, which is classified as Technician, Pathology, specializing in Clinical Laboratory Director, Non-physician

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PRINCETON CLINICAL LABS below.

NPI Profile for
PRINCETON CLINICAL LABS

NPI Number
1205770930
Enumeration Date

(about 8 weeks ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PRINCETON CLINICAL LABS
Primary location
12676 PERCY FOREST LN
JACKSONVILLE, FL 32218-1028
Phone: (904) 840-4888 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
MIAKKA MOON
CEO
Phone: (904) 840-4888
Updated
Certification Date
Apr 14, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
247ZC0005X
- Technician, Pathology / Clinical Laboratory Director, Non-physician (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.