Integrated Regional Laboratories Pathology Services, LLC

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

Legal business name

INTEGRATED REGIONAL LABORATORIES PATHOLOGY SERVICES, LLC

Practice address

12910 Boyette Rd
Riverview, FL 33569-8737

Phone

(813) 571-5193

Fax

(813) 571-5169

NPI assigned

Sep 3, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Jamaine Davis

Title

Chief Operating Officer

Phone

(561) 402-4256

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1788393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1376452532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741087",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741087",
            "telephone_number": "954-507-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12910 BOYETTE RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335698737",
            "telephone_number": "813-571-5193",
            "fax_number": "813-571-5169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED REGIONAL LABORATORIES PATHOLOGY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-03",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMAINE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "561-402-4256"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology & Clinical Pathology Physician in Riverview, FL
• Providers in Riverview, FL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.