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Contact Information

BEECHTREE MOLECULAR LAB LLC
12351 S GATEWAY PARK PLACE
SUITE D-500
DRAPER, UT84020-8402
 Phone: 269-998-0866
 Fax: 801-683-9907
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Medical Laboratory

291U00000X 69 Clinical Laboratory
Indicates primary specialty

NPI Profile & details for BEECHTREE MOLECULAR LAB LLC

NPI Number 1982202453
LBN Legal business name BEECHTREE MOLECULAR LAB LLC
Authorized official GARY DAWSON - (VP OF FINANCE)
Entity Organization
Organization subpart 1 No
Enumeration date 10/15/2020
Last updated 03/28/2024 - About 2 years ago
Identifiers
AK Other 02D2195732 CLIA
UT Other 46D2209724 CLIA
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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