Crossroads Laboratory, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

46D2058259 Issued in UT

Legal business name

CROSSROADS LABORATORY, LLC

Practice address

6337 S Highland Dr Ste 110
Salt Lake City, UT 84121-2107

Phone

(801) 557-9788

NPI assigned

Dec 1, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Michael Russell Brown

Title

Executive Director

Phone

(801) 557-9788

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448928000000",
    "number": "1679948756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6337 S HIGHLAND DR STE 110",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841212107",
            "telephone_number": "801-557-9788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6337 S HIGHLAND DR STE 110",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841212107",
            "telephone_number": "801-557-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-01",
        "last_updated": "2015-12-01",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-557-9788",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "UT",
            "license": "46D2058259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Crossett, DPT
• Ian Crossett, ATC
• Kyle Paul Crossett, ACMHC
• Shellie R Crossett, FNP
• Christine Louise Crossno, PHARM.D., BCOP
• Lisa Croudy, APC
• Abigail Crouse
• Danny Crouse, PA
• Kelly Catherine Crow
• Sheila Crowell, PH.D.

• 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 Dec 1, 2015; 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.