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
8460 CHAMPIONS GATE BLVD, CHAMPIONS GATE, FL 33896-9301
(407) 530-2420
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
10/01/2021
Last updated
10/18/2021
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