Active NPI
Microculture, Inc.
- Clinical Medical Laboratory
- West Jordan, UT
National Provider Identifier
1518048248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- MICROCULTURE, INC.
- Practice address
- 1847 W 9000 S
Suite 102
West Jordan, UT 84088-6596 - Phone
- (801) 352-0995
- Fax
- (801) 352-1039
- NPI assigned
- Oct 18, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. McClaren Harvey Giblette, M ASCP
- Title
- Technical Supervisor Owner
- Phone
- (801) 352-0995
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | UT | Primary |
Addresses
Primary practice location
1847 W 9000 S
Suite 102
West Jordan, UT 84088-6596
Mailing address
1847 W 9000 S
Suite 102
West Jordan, UT 84088-6596
Phone (801) 352-0995
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100727000548 | UT | Part B Supplier - Independent Clinical Laboratory | 6103959267 | Practice locations: West Jordan, UT |
National Provider Directory
National Provider DirectoryLocations
1847 W 9000 S
Ste 102
West Jordan, UT 84088
Phone (801) 352-0995
8841 S Redwood Rd
Ste D3
West Jordan, UT 84088
Phone (801) 561-5729
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1518048248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1847 W 9000 S",
"address_2": "SUITE 102",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840886596",
"telephone_number": "801-352-0995",
"fax_number": "801-352-1039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1847 W 9000 S",
"address_2": "SUITE 102",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840886596",
"telephone_number": "801-352-0995",
"fax_number": "801-352-1039"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MICROCULTURE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-18",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "GIBLETTE",
"authorized_official_first_name": "MCCLAREN",
"authorized_official_middle_name": "HARVEY",
"authorized_official_title_or_position": "TECHNICAL SUPERVISOR OWNER",
"authorized_official_telephone_number": "801-352-0995",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "M ASCP"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "UT",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.