| NPI | 1265533590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY A BUSH AKA DAVIS President 801-298-2191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: UT 5846816-0142) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-08-22 |