Heredilab, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

HEREDILAB, INC

Practice address

1060 E 100 S Ste 109
Salt Lake City, UT 84102-4303

Phone

(801) 328-4254

Fax

(801) 328-9166

NPI assigned

Apr 11, 2019

Organization subpart

No

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

Authorized official

Name

Melody A. Campbell

Title

Vice President

Phone

(801) 583-4123

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward Joseph Campbell, M.D.

  • Pulmonary Disease Physician
  • Salt Lake City, UT
  • NPI 1386741833
  NPD (past)

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1154884575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 E PIONEER FORK RD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081682",
            "telephone_number": "801-558-8946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 E 100 S STE 109",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841024303",
            "telephone_number": "801-328-4254",
            "fax_number": "801-328-9166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEREDILAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-11",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "MELODY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "801-583-4123"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles M. Herald, RN
• Kyle Herauf
• Amy M. Herbener
• Clara Herbers
• Avery Herbert
• Jacob Lyle Hereth
• Sarah Hermak
• Bruce E. Herman, MD
• Christopher Martin Herman, MD
• Deborah Ruth Herman

• All providers in Salt Lake City, UT
• Clinical Medical Laboratory in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.