Organization
ETHIGEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC M DYER (PRESIDENT, CEO)
(888) 578-7872
Entity
Organization
Contact information
Practice address
1904 MICHIGAN AVE, SALT LAKE CITY, UT 84108-1324
(888) 578-7872
Mailing address
1904 MICHIGAN AVE, SALT LAKE CITY, UT 84108-1324
(888) 578-7872
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
05/16/2012
Last updated
05/16/2012
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