Organization
INTEGRATED REGIONAL LABORATORIES PATHOLOGY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JAMAINE DAVIS (CHIEF FINANCIAL OFFICER)
(561) 402-4256
Entity
Organization
Contact information
Practice address
16831 US HIGHWAY 441, MOUNT DORA, FL 32757-6714
(407) 562-0959
Mailing address
PO BOX 741087, ATLANTA, GA 30374-1087
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
11/27/2023
Last updated
01/18/2024
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