Organization
INTEGRATED REGIONAL LABORATORIES PATHOLOGY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JAMAINE DAVIS (CHIEF OPERATIONS OFFICER)
(561) 402-4256
Entity
Organization
Contact information
Practice address
119 OAKFIELD DR, BRANDON, FL 33511-5779
(813) 571-5193
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
06/29/2021
Last updated
06/29/2021
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