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ELYSIUM LABSOURCE NPI 1639560154


NPI Information

NPI: 1639560154
Provider Name: ELYSIUM LABSOURCE

Other Name: ELYSIUM LABORATORY SERVICE

Classification: Physiological Laboratory - 293D00000X
Entity Type: Organization
Address:
2435 W SPENCER CREST DR
BLUFFDALE, UT
ZIP 84065
Phone: (801) 709-9419
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ELYSIUM LABSOURCE is a physiological laboratory in Bluffdale, UT. The provider is a laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. ELYSIUM LABSOURCE NPI is 1639560154. The provider is registered as an organization entity type.
The provider Other Name Is Elysium Laboratory Service.

The provider's business location address is:

2435 W SPENCER CREST DR
BLUFFDALE, UT
ZIP 84065-048
Phone: (801) 709-9419

The provider's authorized official is Michael Harris .
The authorized official title is Medical Director and has the following contact phone number (801) 465-8004.

The enumeration date for this NPI number is 2/6/2015 and was last updated on 3/1/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1293D00000XPhysiological Laboratory46D2091373UTAHYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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