MEDICARE: INTEGRIT LABS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZD0900X	Dermatopathology (Pathology) Physician

General Provider Information

NPI Number	:	1609600311
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRIT LABS, LLC

Provider Business Mailing Address
First Line	:	13201 N 35TH AVE STE 3B
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-1231
Country	:	US
Telephone Number	:	602-777-7761
Fax Number	:	602-777-7116

Provider Business Practice Location Address
First Line	:	13201 N 35TH AVE STE 3B
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-1231
Country	:	US
Telephone Number	:	602-777-7761
Fax Number	:	602-777-7116

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	THALIA TAYLOR
Credential	:
Telephone Number	:	602-777-7761

Provider Enumeration Date	:	08/27/2024
Last Update Date	:	08/27/2024

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Directions to “INTEGRIT LABS, LLC ” Practice Location

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