Healthcare Provider Details

I. General information

NPI: 1891455895
Provider Name (Legal Business Name): HOME CLINIX UTAH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2021
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4337 W OXFORD ST
CEDAR HILLS UT
84062-8638
US

IV. Provider business mailing address

4337 W OXFORD ST
CEDAR HILLS UT
84062-8638
US

V. Phone/Fax

Practice location:
  • Phone: 801-980-1595
  • Fax:
Mailing address:
  • Phone: 801-980-1595
  • Fax: 801-890-3434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SPENCER CLARK
Title or Position: OWNER
Credential:
Phone: 801-980-1595