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NPI Code Detail

MEDICARE: ROCKY MOUNTAIN LABORATORIES LLC

MEDICARE: ROCKY MOUNTAIN LABORATORIES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1700744547
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROCKY MOUNTAIN LABORATORIES LLC
Provider Business Mailing Address
First Line : 12217 S LONE PEAK PKWY
Second Line :
City : DRAPER
State : UT
Zip : 84020-9449
Country : US
Telephone Number : 801-310-4595
Fax Number :
Provider Business Practice Location Address
First Line : 1400 E SOUTHERN AVE
Second Line :
City : TEMPE
State : AZ
Zip : 85282-5691
Country : US
Telephone Number : 801-310-4595
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SCOTT WEISS
Credential :
Telephone Number : 801-310-4595
Provider Enumeration Date : 01/12/2026
Last Update Date : 01/12/2026

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Directions to “ROCKY MOUNTAIN LABORATORIES LLC ” Practice Location

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