Idtox PLLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

212822 Issued in NC

Legal business name

IDTOX PLLC

Practice address

104 State Ave
Suite 104
Clayton, NC 27520-5116

Phone

(919) 243-1831

Fax

(919) 243-1830

NPI assigned

Jan 14, 2016

Organization subpart

No

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

Authorized official

Name

Rachid Idrissi, MD

Title

President

Phone

(919) 359-8643

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660867200000",
    "number": "1942666367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 STATE AVE STE 101-104",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275205116",
            "telephone_number": "919-243-1831",
            "fax_number": "919-243-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 STATE AVE",
            "address_2": "SUITE 104",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275205116",
            "telephone_number": "919-243-1831",
            "fax_number": "919-243-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDTOX PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-14",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A",
        "authorized_official_last_name": "IDRISSI",
        "authorized_official_first_name": "RACHID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-359-8643",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NC",
            "license": "212822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hereward Russell Huggins-Challenger, DDS
• Regina Hughes, LPC
• Steven Mark Hults, DO
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• Clinical Medical Laboratory in Clayton, NC
• Providers in Clayton, NC by specialty
• Clinical Medical Laboratory in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.