Provider Demographics
NPI:1417226093
Name:INTEGRALABS, INC.
Entity Type:Organization
Organization Name:INTEGRALABS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:VENERABLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-313-9671
Mailing Address - Street 1:PO BOX 1994
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:VA
Mailing Address - Zip Code:24203-1994
Mailing Address - Country:US
Mailing Address - Phone:423-328-0527
Mailing Address - Fax:
Practice Address - Street 1:7020 KIT CREEK RD
Practice Address - Street 2:SUITE 240
Practice Address - City:RESEARCH TRIANGLE PARK
Practice Address - State:NC
Practice Address - Zip Code:27709-0008
Practice Address - Country:US
Practice Address - Phone:919-313-9671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-27
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34D2034003291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC34D2034003OtherCLIA
NC34D2034003OtherCLIA