Organization
PROGENITOR MDX, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY R SAMS PHD (PHYSICIAN)
(877) 502-4748
Entity
Organization
Contact information
Practice address
675 S ARAPEEN DR # 103B, SALT LAKE CITY, UT 84108-1223
(877) 502-4748
Mailing address
675 S ARAPEEN DR # 103B, SALT LAKE CITY, UT 84108-1223
(877) 502-4748
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
—
Other
Enumeration date
12/24/2020
Last updated
01/06/2021
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