Axial Biotech, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

46D1077919 Issued in UT

Legal business name

AXIAL BIOTECH, INC.

Practice address

2749 Parleys Way
Suite 200
Salt Lake City, UT 84109-1660

Phone

(801) 984-9100

Fax

(801) 994-1000

NPI assigned

Mar 2, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Ward, M.D.

Title

Chief Scientific Officer

Phone

(801) 984-9137

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235952000000",
    "number": "1437399508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2749 PARLEYS WAY",
            "address_2": "SUITE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841091660",
            "telephone_number": "801-984-9100",
            "fax_number": "801-994-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2749 PARLEYS WAY",
            "address_2": "SUITE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841091660",
            "telephone_number": "801-984-9100",
            "fax_number": "801-994-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIAL BIOTECH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-02",
        "last_updated": "2009-03-02",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CHIEF SCIENTIFIC OFFICER",
        "authorized_official_telephone_number": "801-984-9137",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "UT",
            "license": "46D1077919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Max Wilson Aycock, MD
• Debra Ayer

• 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 Mar 2, 2009; 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.