| NPI | 1194203208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALLIN CRAIG JOHNSTON Owner 801-898-5536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: TX 45D2149383) |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2022-04-10 |