Organization
PRECISION DIAGNOSTIC SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STUART B CANNON BS MBA (CHEIF EXECUTIVE OFFICER)
(801) 266-0399
Entity
Organization
Contact information
Practice address
4885 S 900 E STE 107, SALT LAKE CITY, UT 84117-3905
(801) 266-0399
(801) 266-0421
Mailing address
4885 S 900 E STE 107, SALT LAKE CITY, UT 84117-3905
(801) 266-0399
(801) 266-0421
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
44618
UT
291U00000X
Clinical Medical Laboratory
4611
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73047
PEHP
UT
01
—
P00059272
RR MEDICARE
UT
01
—
QM0000064662
ALITUS
UT
Enumeration date
09/20/2006
Last updated
10/31/2008
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