Sorenson Genomics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SORENSON GENOMICS, LLC

Practice address

2495 S West Temple
Salt Lake City, UT 84115-3057

Phone

(801) 462-1400

Fax

(801) 462-1404

NPI assigned

Aug 19, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Douglas R. Fogg

Title

Chief Operating Officer

Phone

(801) 462-1409

Specialties & licenses 1

Addresses

Other names 1

• Sorenson Genomics - Identigene Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1063792299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 S WEST TEMPLE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841153060",
            "telephone_number": "801-462-1400",
            "fax_number": "801-462-1404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 S WEST TEMPLE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841153057",
            "telephone_number": "801-462-1400",
            "fax_number": "801-462-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SORENSON GENOMICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-19",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "FOGG",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "801-462-1409",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sorenson Genomics - Identigene",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lynae Clark Sorensen, APRN
• Lynn R Sorensen, S.S.W.
• Oryslava Sorensen
• Philicia Dawn Sorensen
• Tyler D. Sorensen, AU.D.
• Carl Jay Sorenson, RPH
• Kalli Sorenson
• Michelle Allen Sorenson, SSW
• Noah Christopher Sorenson
• Travis D Sorenson, LCSW

• Clinical Medical Laboratory in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinical Medical Laboratory in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.