Organization Active NPI

Microculture, Inc.

  • Clinical Medical Laboratory
  • West Jordan, UT
National Provider Identifier
1518048248
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
O20100727000548 UT Part B Supplier - Independent Clinical Laboratory 6103959267 Practice locations: West Jordan, UT

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.