MEDICARE: ARUP LABORATORIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)	5084485-3601	UT

General Provider Information

NPI Number	:	1982694931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARUP LABORATORIES

Provider Business Mailing Address
First Line	:	500 CHIPETA WAY
Second Line	:
City	:	SLC
State	:	UT
Zip	:	84108-1221
Country	:	US
Telephone Number	:	800-242-2787
Fax Number	:	801-584-5207

Provider Business Practice Location Address
First Line	:	500 CHIPETA WAY
Second Line	:
City	:	SLC
State	:	UT
Zip	:	84108-1221
Country	:	US
Telephone Number	:	800-242-2787
Fax Number	:	801-584-5207

Authorized Official
Title or Position	:	LABORATORY DIRECTOR
Name	:	EDWARD ASHWOOD
Credential	:	M.D.
Telephone Number	:	800-242-2787

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	08/06/2008

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