Organization
INDEPENDENT CLINICAL LABORATORIES LLC
Active
Other names
KorPath
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL NODES (COO)
(843) 754-7748
Entity
Organization
Contact information
Practice address
3110 CHERRY PALM DR, SUITE 340, TAMPA, FL 33619-8304
(813) 932-0374
(813) 931-0658
Mailing address
22 WESTEDGE ST STE 800, CHARLESTON, SC 29403-6984
(854) 429-1069
(833) 247-4091
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
800001312
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030103500
—
FL
Enumeration date
11/17/2006
Last updated
06/04/2025
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