Dr. Ly Luu, M.D.
Pathology, Clinical Pathology in Salt Lake City, UT. Individual provider (NPI-1).
NPI number1689120909
StatusActive
Last updated in NPPESNov 12, 2020
Details
- NPI
- 1689120909
- Entity type
- Individual (NPI-1)
- Name
- Dr. Ly Luu
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 28, 2016
- Certification date
- Nov 12, 2020
- Last updated
- Nov 12, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PATHOLOGY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- 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 |
|---|---|---|---|---|
| 207ZC0006X | Pathology, Clinical Pathology | 11291133-1205 | UT | Yes |
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | 11291133-1205 | UT | |
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | 7691 | NE |
Practice location
15 N Medical Dr Ste 1100Salt Lake City, UT 84112-1100
Phone 801-581-4390
Mailing address
15 N Medical Dr Ste 1100Salt Lake City, UT 84112-1100
Phone 801-581-4390
Other practice locations
601 N. 30th St - Cu Department Of Pathology
Omaha, NE 68131
Omaha, NE 68131
Phone 402-717-0947 · Fax 402-280-1237
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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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All 10 Clinical Pathology Physician providers in Salt Lake City · All 24,510 providers in Salt Lake City
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