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IDESTA MEDICAL INC
NPI 1063185015
Technician, Pathology - Phlebotomy in Tyrone, GA

Active since July 27, 2021
1015 TYRONE RD # 410-C, TYRONE, GA 30290(470) 818-2264(866) 984-3729 Get Directions Write a Review

NPPES record last updated: June 10, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 12, 2024, Sep 26, 2024, Jul 27, 2021 (3 updates tracked since 2021).

About Idesta Medical Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IDESTA MEDICAL INC (NPI 1063185015) is a healthcare organization registered as a phlebotomy in Tyrone, Georgia and active in the NPI registry since July 2021. The organization lists Idesta Ralph, Owner, as its authorized official.

NPPES Registry Identity

NPI1063185015
Entity TypeOrganization
Primary Taxonomy246RP1900X
Legal Business NameIDESTA MEDICAL INC
Location Address1015 TYRONE RD # 410-CTyrone, GA 30290-2407
Mailing Address4827 Old National Hwy Unit 2032College Park, GA 30337-6234 · (239) 895-7910 · Fax (866) 984-3729
Phone(470) 818-2264
Fax(866) 984-3729
Organization SubpartNo
Authorized OfficialIdesta RalphOwner · (239) 895-7910
Enumeration DateJuly 27, 2021
Last NPPES UpdateJune 10, 20263 updates tracked since enumeration
NPPES CertifiedJune 10, 2026
✔ NPI 1063185015 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyTechnician, Pathology · PhlebotomyTechnologists, Technicians & Other Technical Service Providers
Taxonomy Code246RP1900X
Also ListedPathology · Blood Banking & Transfusion MedicineTaxonomy 207ZB0001X
Also ListedClinic/CenterTaxonomy 261Q00000X
1015 TYRONE RD # 410-C, Tyrone, GA 30290
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

IDESTA RALPH
Technician, Pathology (Phlebotomy)
1015 TYRONE RD # 410-C
TYRONE, GA 30290
Fayette County (470) 818-2264

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Idesta Medical Inc's NPI number?

The NPI number for Idesta Medical Inc is 1063185015. It was assigned to this organization in the NPPES registry on July 27, 2021.

Where is Idesta Medical Inc located?

Idesta Medical Inc is located at 1015 Tyrone Rd # 410-C, Tyrone, GA 30290. The listed phone number is (470) 818-2264.

What is Idesta Medical Inc's specialty?

The primary specialty registered for this NPI is Technician, Pathology, specializing in Phlebotomy, with taxonomy code 246RP1900X.

When was this NPI record last updated?

The NPPES record for Idesta Medical Inc was last updated on June 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.