Healthcare Provider Details

I. General information

NPI: 1477921112
Provider Name (Legal Business Name): JML LAB SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2015
Last Update Date: 09/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10965 S STATE ST
SANDY UT
84070-4270
US

IV. Provider business mailing address

2235 W MOUNTAINSIDE CIR
BLUFFDALE UT
84065-3013
US

V. Phone/Fax

Practice location:
  • Phone: 801-542-0589
  • Fax: 207-237-2774
Mailing address:
  • Phone: 801-542-0589
  • Fax: 206-237-2774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateUT

VIII. Authorized Official

Name: JAMES CUNNINGHAM
Title or Position: PRESIDENT
Credential:
Phone: 801-542-0589