Provider Demographics
NPI:1578259875
Name:ICOMPLY TESTING SOLUTIONS
Entity Type:Organization
Organization Name:ICOMPLY TESTING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:LATRELL
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-859-5981
Mailing Address - Street 1:555 S POMPANO PKWY STE 3
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-3016
Mailing Address - Country:US
Mailing Address - Phone:954-859-5981
Mailing Address - Fax:954-859-5586
Practice Address - Street 1:555 S POMPANO PKWY STE 3
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-3016
Practice Address - Country:US
Practice Address - Phone:954-859-5981
Practice Address - Fax:954-859-5586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory