Heredilab, INC
Clinical Medical Laboratory in Salt Lake City, UT. Organization (NPI-2).
Details
- NPI
- 1154884575
- Entity type
- Organization (NPI-2)
- Legal business name
- Heredilab, INC
- Organization subpart
- No
- Enumeration date
- Apr 11, 2019
- Last updated
- Jun 11, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 291U00000X | Clinical Medical Laboratory | – | – | Yes |
Practice location
1060 E 100 S Ste 109Salt Lake City, UT 84102-4303
Phone 801-328-4254 · Fax 801-328-9166
Mailing address
5505 E Pioneer Fork RdSalt Lake City, UT 84108-1682
Phone 801-558-8946
Authorized official
Melody A. Campbell
Vice President
8015834123
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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