Healthcare Provider Details

I. General information

NPI: 1992619597
Provider Name (Legal Business Name): MEDPOINT LABORATORY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 US-51
BROOKHAVEN MS
39601
US

IV. Provider business mailing address

5900 BALCONES DR
AUSTIN TX
78731-4257
US

V. Phone/Fax

Practice location:
  • Phone: 945-206-0473
  • Fax:
Mailing address:
  • Phone: 945-206-0473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateNULL

VIII. Authorized Official

Name: KEVIN GRUBB
Title or Position: CEO
Credential: MANAGER
Phone: 945-206-0473