# ICON LABS INC.

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

## Provider details

- **NPI number:** 1548974157
- **Authorized official:** DIVINA BRINKLEY (PRESIDENT)
- **Authorized official phone:** (954) 854-8971

## Contact information

- **Practice address:** 4891 NW 103RD AVE STE 11J, SUNRISE, FL 33351-7955
- **Practice address phone:** (954) 854-8971
- **Mailing address:** 5944 CORAL RIDGE DR \# 246, CORAL SPRINGS, FL 33076-3300
- **Mailing address phone:** (954) 854-8971

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 247ZC0005X | Clinical Laboratory Director (Non-physician) | — | NULL | Yes |
| 247ZC0005X | Clinical Laboratory Director (Non-physician) | — | — | Yes |

## Other

- **Enumeration date:** 01/09/2023
- **Last updated:** 01/09/2023