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General NPI Number Information
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NPI Number | 1154039436
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Entity Type | Organization
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Legal Business Name | NATIONAL MOLECULAR DIAGNOSTICS
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Dates
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Enumeration Date | 11/07/2022
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 1955 W GROVE PKWY STE 201
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-6731
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Country | US
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Telephone | 385-248-0082
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Fax |
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Provider Business Mailing Address
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Address Line | 1955 W GROVE PKWY STE 201
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-6731
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Country | US
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Telephone | 385-248-0082
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Fax |
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | STEELE ANDERSON
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Credential |
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Telephone | 801-336-8014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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