Provider Demographics
NPI:1912578865
Name:MOUNTAIN VIEW DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:MOUNTAIN VIEW DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLASIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-716-7008
Mailing Address - Street 1:1051 S 500 W STE C
Mailing Address - Street 2:
Mailing Address - City:WOODS CROSS
Mailing Address - State:UT
Mailing Address - Zip Code:84010-8350
Mailing Address - Country:US
Mailing Address - Phone:801-893-0181
Mailing Address - Fax:385-257-6258
Practice Address - Street 1:1051 S 500 W STE C
Practice Address - Street 2:
Practice Address - City:WOODS CROSS
Practice Address - State:UT
Practice Address - Zip Code:84010-8350
Practice Address - Country:US
Practice Address - Phone:801-893-0181
Practice Address - Fax:385-257-6258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory