Organization
INTEGRALABS MDG INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REYNALDO MARTINEZ (PRESIDENT)
(423) 328-3026
Entity
Organization
Contact information
Practice address
2175 HWY 75, STE #6, BLOUNTVILLE, TN 37617
(423) 328-0527
(423) 328-3027
Mailing address
PO BOX 1736, BRISTOL, VA 24203-1736
(423) 328-3026
(423) 328-3027
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
44D2061419
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44D2061419
CLIA
TN
Enumeration date
08/19/2013
Last updated
01/29/2024
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