Universal newborn hearing screening in North Carolina began in 2000 under the auspices of the North Carolina Department of Health and Human Services Early Hearing Detection and Intervention Program (NC-EHDI). Despite initial success, loss to follow-up/lost to documentation for diagnostic testing was problematic. To address this, the NC-EHDI received U.S. Department of Health and Human Services Health Resources and Services Administration lost to follow-up funding to in part fund a pilot “Teleaudiology Project” in 2010 to provide services for infants in eastern North Carolina. This part of the state is a traditionally underserved area. The project involved a partnership with East Carolina University. The project’s goals were to provide infant diagnostic evaluations in rural eastern counties and to establish a coordinated system for the delivery of audiological evaluations for infants whose families experience economic and geographic barriers to service. Project planning preparation and preliminaries, project service model, and outcome data are presented. From 2011 to 2015, outcome data provide positive proof-of-concept for a teleaudiology model in meeting national recommendations for providing diagnostic testing of infants following screening referral in a timely manner. In addition, the endeavor provides graduate audiology students with a unique didactic and clinical experience in teleaudiology.