Organization
IHC HEALTH SERVICES INC
Active
Other names
Bryner Clinic Independent Lab
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDA C LECKMAN MD (CEO/VP INTERMOUNTAIN MEDICAL GROUP)
(801) 442-3974
Entity
Organization
Contact information
Practice address
525 E 100 S, #500, SALT LAKE CITY, UT 84102-4210
(801) 519-7126
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 519-7126
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
19950476
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46D0523471
CLIA
UT
Enumeration date
03/26/2008
Last updated
12/05/2008
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