| NPI | 1871854414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW O LEAVITT Member 801-225-5407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: UT 65908671205) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2012-10-18 |