# ORIGIN DIAGNOSTICS

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

## Provider details

- **NPI number:** 1578445821
- **Authorized official:** BRIAN DREW (VP INNOVATION)
- **Authorized official phone:** (317) 502-5695

## Contact information

- **Practice address:** 12574 FLAGLER CENTER BLVD STE 101-63, JACKSONVILLE, FL 32258-2614
- **Practice address phone:** (800) 440-6695
- **Practice address fax:** (323) 203-1648
- **Mailing address:** 12574 FLAGLER CENTER BLVD STE 101-63, JACKSONVILLE, FL 32258-2614
- **Mailing address phone:** (800) 440-6695
- **Mailing address fax:** (323) 203-1648

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/25/2025
- **Last updated:** 07/25/2025