Icon Labs Inc.

Primary specialty

Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X

Legal business name

ICON LABS INC.

Practice address

4891 NW 103Rd Ave Ste 11J
Sunrise, FL 33351-7955

Phone

(954) 854-8971

NPI assigned

Jan 9, 2023

Organization subpart

No

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

Authorized official

Name

Divina Brinkley

Title

President

Phone

(954) 854-8971

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1548974157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5944 CORAL RIDGE DR # 246",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763300",
            "telephone_number": "954-854-8971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4891 NW 103RD AVE STE 11J",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333517955",
            "telephone_number": "954-854-8971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICON LABS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "BRINKLEY",
        "authorized_official_first_name": "DIVINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-854-8971"
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark J. Hutchens, CRNA
• Leo Ngoc Huynh, DO
• Alexis Hyatt
• Danielle Hyatt, MSW
• Icom Sunrise LLC
• Ics Radiology, Inc.
• Ideal Medical Supplies LLC
• Ig Therapeutic Services LLC
• Burak Ilsin, MD
• Marvin Imbat

• Clinical Laboratory Director (Non-physician) in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Clinical Laboratory Director (Non-physician) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.