Integralabs MDG Incorporated

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

44D2061419 Issued in TN

Legal business name

INTEGRALABS MDG INCORPORATED

Practice address

2175 Hwy 75
Ste #6
Blountville, TN 37617

Phone

(423) 328-0527

Fax

(423) 328-3027

NPI assigned

Aug 19, 2013

Last updated

Jan 29, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Reynaldo Martinez

Title

President

Phone

(423) 328-3026

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1487087003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1736",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242031736",
            "telephone_number": "423-328-3026",
            "fax_number": "423-328-3027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 HWY 75",
            "address_2": "STE #6",
            "city": "BLOUNTVILLE",
            "state": "TN",
            "postal_code": "37617",
            "telephone_number": "423-328-0527",
            "fax_number": "423-328-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRALABS MDG INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "REYNALDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-328-3026"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TN",
            "license": "44D2061419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "44D2061419",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barry Lee Honeycutt, RN, DON
• Barry L Hopper, DDS
• Dawn Marie Horn, LPN
• Wallace Carlo Hoskins, DDS
• David Michael Hurley, PHARMD, MBA
• Ricky Lee Johnson Jr.
• Jones Adaptive Mobility LLC
• Everett Russell Jones Jr., M.D.
• Madison T Jones
• Samuel Riddle Jones, M.D.

• Clinical Medical Laboratory in Blountville, TN
• Providers in Blountville, TN by specialty
• Clinical Medical Laboratory in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.