Provider Demographics
NPI:1750915658
Name:IDBYDNA INC.
Entity type:Organization
Organization Name:IDBYDNA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLABERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-983-8330
Mailing Address - Street 1:675 S ARAPEEN DR STE 301
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-1223
Mailing Address - Country:US
Mailing Address - Phone:801-983-8330
Mailing Address - Fax:
Practice Address - Street 1:675 S ARAPEEN DR STE 301
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1223
Practice Address - Country:US
Practice Address - Phone:801-983-8330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory