Beechtree Molecular Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

BEECHTREE MOLECULAR LAB LLC

Practice address

12351 S Gateway Park Place
Suite D-500
Draper, UT 84020-8402

Phone

(269) 998-0866

Fax

(801) 683-9907

NPI assigned

Oct 15, 2020

Organization subpart

No

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

Authorized official

Name

Gary Dawson

Title

VP of Finance

Phone

(801) 893-2773

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• BT Molecular LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• BT Molecular LLC

  • Clinical Medical Laboratory
  • Draper, UT
  • NPI 1932867371
  NPPES parent name

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

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1982202453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12351 S GATEWAY PARK PL STE D-700",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209581",
            "telephone_number": "801-893-2773",
            "fax_number": "801-683-9907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12351 S GATEWAY PARK PLACE",
            "address_2": "SUITE D-500",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208402",
            "telephone_number": "269-998-0866",
            "fax_number": "801-683-9907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Calista Ct Ste 102",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995183000",
            "country_code": "US",
            "telephone_number": "907-917-0310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BEECHTREE MOLECULAR LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-15",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "801-893-2773"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "46D2209724",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "02D2195732",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BT Molecular LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BT Molecular LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kirsten Beck
• Lacie Beck
• Joslyn Beckstead
• John Thomas Bedford Jr., D.P.T., O.C.S
• Beechtree Diagnostics LLP
• Behavioral Health Solutions of Utah
• Andrew Charles Behunin, D.O.
• Kendyl Bell
• Madison Lynn Bell, RN
• Melissa Bell

• Clinical Medical Laboratory in Draper, UT
• Providers in Draper, 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 28, 2024; 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.