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ICON LABS INC.
NPI 1548974157
Pathology - Clinical Laboratory Director, Non-physician in Sunrise, FL

Active since January 09, 2023CLIA 10D2273364 · Waiver
4891 NW 103RD AVE STE 11J, SUNRISE, FL 33351(954) 854-8971 Get Directions Write a Review

NPPES record last updated: January 9, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Icon Labs Inc. NPPES

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

ICON LABS INC. (NPI 1548974157) is a healthcare organization registered as a clinical laboratory director, non-physician in Sunrise, Florida and active in the NPI registry since January 2023. The organization holds a CLIA Waiver certificate valid through December 11, 2026 and lists Divina Brinkley, President, as its authorized official.

NPPES Registry Identity

NPI1548974157
Entity TypeOrganization
Primary Taxonomy247ZC0005X
Legal Business NameICON LABS INC.
Location Address4891 NW 103RD AVE STE 11JSunrise, FL 33351-7955
Mailing Address5944 Coral Ridge Dr # 246Coral Springs, FL 33076-3300 · (954) 854-8971
Phone(954) 854-8971
Organization SubpartNo
Authorized OfficialDivina BrinkleyPresident · (954) 854-8971
Enumeration DateJanuary 9, 2023
NPPES CertifiedJanuary 9, 2023
✔ NPI 1548974157 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Clinical Laboratory Director, Non-physicianTechnologists, Technicians & Other Technical Service Providers
Taxonomy Code247ZC0005X
Definition
An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405.
4891 NW 103RD AVE STE 11J, Sunrise, FL 33351
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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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2273364

Icon Labs Inc · Sunrise, FL
Active · expires Dec 11, 2026
CLIA Number10D2273364
Laboratory TypeCovid Waived Lab
Certificate Effective DateDecember 12, 2024
Certificate Expiration DateDecember 11, 2026
Laboratory DirectorMelvin Marroquin
Laboratory Phone(305) 722-6921
Laboratory LocationIcon Labs Inc4891 NW 103rd Ave #11j, Sunrise, FL 33351
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 Icon Labs Inc.'s NPI number?

The NPI number for Icon Labs Inc. is 1548974157. It was assigned to this organization in the NPPES registry on January 9, 2023.

Where is Icon Labs Inc. located?

Icon Labs Inc. is located at 4891 NW 103rd Ave Ste 11J, Sunrise, FL 33351. The listed phone number is (954) 854-8971.

What is Icon Labs Inc.'s specialty?

The primary specialty registered for this NPI is Pathology, specializing in Clinical Laboratory Director, Non-physician, with taxonomy code 247ZC0005X.

Does Icon Labs Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2273364) is associated with this NPI, valid through December 11, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Icon Labs Inc. was last updated on January 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.