Organization
COTTONWOOD DIAGNOSTICS LLP
Active
Organization
COTTONWOOD DIAGNOSTICS LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MURANO (OWNER)
(801) 201-1763
Entity
Organization
Contact information
Practice address
12351 S GATEWAY PARK PL, SUITE D-600, DRAPER, UT 84020-9581
(801) 201-1763
(801) 683-9907
Mailing address
12351 S GATEWAY PARK PL, SUITE D-700, DRAPER, UT 84020-9581
(801) 201-1763
(801) 683-9907
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027544
COLA
—
01
—
46D2118660
CLIA
—
Enumeration date
09/26/2016
Last updated
12/28/2016
Update your record
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