MEDICARE: PRECISION DIAGNOSTIC SERVICES, INC.

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
1	291U00000X	Clinical Medical Laboratory	4611	UT
2	291U00000X	Clinical Medical Laboratory	44618	UT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00059272	OTHER	UT	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	QM0000064662	OTHER	UT	ALITUS
3	73047	OTHER	UT	PEHP

General Provider Information

NPI Number	:	1871691246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION DIAGNOSTIC SERVICES, INC.

Provider Business Mailing Address
First Line	:	4885 S 900 E STE 107
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-3905
Country	:	US
Telephone Number	:	801-266-0399
Fax Number	:	801-266-0421

Provider Business Practice Location Address
First Line	:	4885 S 900 E STE 107
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-3905
Country	:	US
Telephone Number	:	801-266-0399
Fax Number	:	801-266-0421

Authorized Official
Title or Position	:	CHEIF EXECUTIVE OFFICER
Name	:	MR. STUART B CANNON
Credential	:	BS MBA
Telephone Number	:	801-266-0399

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	10/31/2008

Similar Medicare Providers

1336249572 — PRECISION HEALTH SERVICES, INC.
Practice Location Address:

4885 S 900 E STE 107
SALT LAKE CITY, UT
84117-3905

Practice Phone: 801-266-0399
Practice Fax:

1184828816 — PRECISION HEALTH SERVICES
Practice Location Address:

4885 S 900 E STE 107
SALT LAKE CITY, UT
84117-3905

Practice Phone: 801-266-0399
Practice Fax:

1497959019 — MRS. VICKY N. ROBBINS R.R.T.
Practice Location Address:

4885 S 900 E STE 107
SALT LAKE CITY, UT
84117-3905

Practice Phone: 801-266-0399
Practice Fax:

1376063404 — MRS. TIFFANI HORNE BS RRT
Practice Location Address:

4885 S 900 E STE 107
SALT LAKE CITY, UT
84117-3905

Practice Phone: 801-266-0399
Practice Fax: 801-266-0421

1023045341 — DR. KIRBY CHARLES JOHNSON DDS
Practice Location Address:

3905 SILVER LAKE RD
ST ANTHONY, MN
55421

Practice Phone: 612-788-9246
Practice Fax: 612-788-5511

1306873575 — DR. DANIEL EDGER SAMPSON MD DDS
Practice Location Address:

3905 SILVER LAKE RD
ST ANTHONY, MN
55421

Practice Phone: 612-788-9246
Practice Fax: 612-788-5511

Directions to “PRECISION DIAGNOSTIC SERVICES, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.