Organization
SLEEP DIAGNOSTICS OF UTAH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHIRLEY A BUSH AKA DAVIS (PRESIDENT)
(801) 298-2191
Entity
Organization
Contact information
Practice address
425 MEDICAL DR STE 208, BOUNTIFUL, UT 84010-4942
(801) 298-2191
(801) 298-2373
Mailing address
425 MEDICAL DR STE 208, BOUNTIFUL, UT 84010-4942
(801) 298-2191
(801) 298-2373
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
5846816-0142
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30147200500001
BLUE CROSS BLUE SHIELD
UT
Enumeration date
09/26/2006
Last updated
08/22/2020
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