| NPI | 1679745467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER W. HANSEN Owner/Manager 801-721-0415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: UT 103889-5701) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2008-04-01 |