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General NPI Number Information
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NPI Number | 1649094897
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Entity Type | Organization
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Legal Business Name | UTAH CLINICAL LABORATORY LLC
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 3292 E DESERET DR STE 109A-B
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City | SAINT GEORGE
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State | UT
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Zip | 84790-5633
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Country | US
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Telephone | 385-421-2016
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Fax | 435-775-2127
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Provider Business Mailing Address
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Address Line | 3292 E DESERET DR STE 109A-B
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City | SAINT GEORGE
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State | UT
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Zip | 84790-5633
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Country | US
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Telephone | 385-421-2016
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Fax | 435-775-2127
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Authorized Official
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Title or Position | CEO
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Name | JAHANGEER ALI
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Credential |
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Telephone | 385-421-2016
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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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