Sports Drug Testing Laboratory, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SPORTS DRUG TESTING LABORATORY, LLC

Practice address

10644 S Jordan Gtwy Ste 200
South Jordan, UT 84095-4036

Phone

(801) 994-9454

Fax

(801) 994-9455

NPI assigned

Jul 29, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Kim Marie Monti

Title

Cfo/Cao/Treasurer

Phone

(801) 994-9464

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602547200000",
    "number": "1376152983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10644 S JORDAN GTWY STE 200",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954036",
            "telephone_number": "801-994-9454",
            "fax_number": "801-994-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10644 S JORDAN GTWY STE 200",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954036",
            "telephone_number": "801-994-9454",
            "fax_number": "801-994-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS DRUG TESTING LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A",
        "authorized_official_last_name": "MONTI",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CFO/CAO/TREASURER",
        "authorized_official_telephone_number": "801-994-9464",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in South Jordan, UT
• Providers in South Jordan, 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 Oct 13, 2020; 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.