HEREDILAB, INC


Address: 1060 E 100 S Ste 109, Salt Lake City, UT 84102-4303
Phone: 8013284254

HEREDILAB, INC (NPI# 1154884575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154884575
Entity Type Organization
Organization Name HEREDILAB, INC
Practice Address 1060 E 100 S Ste 109
Salt Lake City
UT 84102-4303
Mailing Address 5505 E Pioneer Fork Rd
Salt Lake City
UT 84108-1682
Practice Telephone 8013284254
Practice Fax Number 8013289166
Mailing Telephone 8015588946
Enumeration Date 2019-04-11
Last Update Date 2019-06-11
Authorized Official Name MELODY A. CAMPBELL (VICE PRESIDENT)
Authorized Official Telephone 8015834123
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 291U00000X Clinical Medical Laboratory Laboratories

Other Provider Identifier

State Issuer Identifier Type Code
NONE NONE 01

Other Data Sources

Entity Type Entity Name Entity Address
New York State Corporations HEREDILAB, INC. 5505 E Pioneer Fork Rd, Salt Lake City, Ut 84108

Office Location

Street Address 1060 E 100 S STE 109
City SALT LAKE CITY
State UT
Zip Code 84102-4303

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Taxonomy Information

Taxonomy Code 291U00000X
Grouping Laboratories
Classification Clinical Medical Laboratory

Taxonomy Definition

(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186.

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1508125196 Ethigen, LLC Clinical Medical Laboratory 1904 Michigan Ave, Salt Lake City, UT 84108-1324 2012-05-16
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Competitor

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City SALT LAKE CITY
Zip Code 84102

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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