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General NPI Number Information
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NPI Number | 1518048248
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Entity Type | Organization
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Legal Business Name | MICROCULTURE, INC.
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1847 W 9000 S SUITE 102
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City | WEST JORDAN
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State | UT
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Zip | 84088-6596
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Country | US
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Telephone | 801-352-0995
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Fax | 801-352-1039
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Provider Business Mailing Address
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Address Line | 1847 W 9000 S SUITE 102
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City | WEST JORDAN
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State | UT
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Zip | 84088-6596
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Country | US
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Telephone | 801-352-0995
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Fax | 801-352-1039
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Authorized Official
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Title or Position | TECHNICAL SUPERVISOR OWNER
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Name | MR. MCCLAREN HARVEY GIBLETTE
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Credential | M ASCP
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Telephone | 801-352-0995
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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 | UT
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