Provider Demographics
NPI:1114697950
Name:AML DIAGNOSTIC LABORATORY UTAH AMERILABS
Entity Type:Organization
Organization Name:AML DIAGNOSTIC LABORATORY UTAH AMERILABS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:940-300-2725
Mailing Address - Street 1:4019 W 12600 S STE 200
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:UT
Mailing Address - Zip Code:84096-7406
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4019 W 12600 S STE 200
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84096-7406
Practice Address - Country:US
Practice Address - Phone:801-515-4114
Practice Address - Fax:385-274-0903
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERI-LABS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory