# INTEGRATED REGIONAL LABORATORIES PATHOLOGY SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376452532
- **Authorized official:** MICHAEL JAMAINE DAVIS (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (561) 402-4256

## Contact information

- **Practice address:** 12910 BOYETTE RD, RIVERVIEW, FL 33569-8737
- **Practice address phone:** (813) 571-5193
- **Practice address fax:** (813) 571-5169
- **Mailing address:** PO BOX 741087, ATLANTA, GA 30374-1087
- **Mailing address phone:** (954) 507-6780

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/03/2026
- **Last updated:** 09/03/2026