Provider First Line Business Practice Location Address:
15 N MEDICAL DR
Provider Second Line Business Practice Location Address:
PATHOLOGY DEPARTMENT ROOM 2100
Provider Business Practice Location Address City Name:
SALT LAKE CITY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84132-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-585-6877
Provider Business Practice Location Address Fax Number:
801-585-6666
Provider Enumeration Date:
10/13/2006