Provider Demographics
NPI:1598170201
Name:ASPEN CLINICAL RESEARCH LLC
Entity Type:Organization
Organization Name:ASPEN CLINICAL RESEARCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-224-5600
Mailing Address - Street 1:1215 S 1680 W
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-4939
Mailing Address - Country:US
Mailing Address - Phone:801-356-5555
Mailing Address - Fax:801-224-6010
Practice Address - Street 1:1215 S 1680 W
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-4939
Practice Address - Country:US
Practice Address - Phone:801-356-5555
Practice Address - Fax:801-224-6010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-23
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory