Organization
MYRIAD GENETIC LABORATORIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER D HO (SR. VP PAYER MARKETS)
(801) 584-3600
Entity
Organization
Contact information
Practice address
322 N 2200 W, SALT LAKE CITY, UT 84116-2922
(801) 584-3600
(801) 584-3615
Mailing address
320 WAKARA WAY, SALT LAKE CITY, UT 84108-1214
(801) 584-3600
(801) 883-3472
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
46D0880690
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010210186
—
VA
05
—
02668124
—
NY
05
—
200062220A
—
OK
05
—
200508920A
—
IN
05
—
409661400
—
MD
05
—
42122333
—
NM
01
—
46D2094383
CLIA
UT
05
—
46D2094383
—
UT
05
—
56130236
—
CO
05
—
706248507
—
MO
05
—
82350800
—
WI
05
—
912768
—
AZ
05
—
LB323UT
—
AK
Enumeration date
08/12/2006
Last updated
01/27/2025
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