| NPI | 1457722092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON DOUGLAS COOMBS Owner 801-350-1716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: ID P1825) |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2015-10-08 |