Provider Demographics
NPI:1316407265
Name:INTEGRITY DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:INTEGRITY DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CIO
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-657-9011
Mailing Address - Street 1:1645 PALM BEACH LAKES BLVD STE 1010
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2218
Mailing Address - Country:US
Mailing Address - Phone:304-657-9011
Mailing Address - Fax:
Practice Address - Street 1:12855 N 40 DR STE 345
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8622
Practice Address - Country:US
Practice Address - Phone:304-657-9011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory