Active NPI
Integrated Regional Laboratories Pathology Services, LLC
- Anatomic Pathology & Clinical Pathology Physician
- St Augustine, FL
National Provider Identifier
1558261321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- Legal business name
- INTEGRATED REGIONAL LABORATORIES PATHOLOGY SERVICES, LLC
- Practice address
- 1780 Woodlawn Rd
St Augustine, FL 32084-1484 - Phone
- (954) 507-6780
- NPI assigned
- Nov 6, 2026
- Last updated
- Nov 6, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Jamaine Davis
- Title
- Coo
- Phone
- (561) 402-4256
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | Primary |
Addresses
Primary practice location
1780 Woodlawn Rd
St Augustine, FL 32084-1484
Mailing address
PO Box 741087
Atlanta, GA 30374-1087
Phone (954) 507-6780
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1793923200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1793923200000",
"number": "1558261321",
"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": "1780 WOODLAWN RD",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320841484",
"telephone_number": "954-507-6780"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTEGRATED REGIONAL LABORATORIES PATHOLOGY SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-11-06",
"last_updated": "2026-11-06",
"certification_date": "2026-11-06",
"status": "A",
"authorized_official_last_name": "DAVIS",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "JAMAINE",
"authorized_official_title_or_position": "COO",
"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": []
}Other providers in St Augustine, FL
- Institute of Internal Medicine P a
- Integrated Community Oncology Network LLC (Cancer Specialists of NF)
- Integrated Community Oncology Network LLC (Cancer Care Specialists of North Florida)
- Integrated Community Oncology Network LLC (Florida Radiation Oncology Group)
- Integrated Community Oncology Network LLC
- Integrative Pain Solutions, PL
- Interim HHA of St Augustine Inc
- Internal Medicine Associates of St Johns County PA
- Intuition Wellness, LLC
- Julia Ann Isaac
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.