Provider Demographics
NPI:1750192886
Name:INTEGRITY HEALTH LAB LLC
Entity type:Organization
Organization Name:INTEGRITY HEALTH LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIDAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMOUD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-771-2200
Mailing Address - Street 1:370 E 12 MILE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-2500
Mailing Address - Country:US
Mailing Address - Phone:248-771-2200
Mailing Address - Fax:248-771-2201
Practice Address - Street 1:370 E 12 MILE RD STE 203
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-2500
Practice Address - Country:US
Practice Address - Phone:248-771-2200
Practice Address - Fax:248-771-2201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory