Organization
BEECHTREE MOLECULAR LAB LLC
Active
Other names
BT Molecular LLC
Organization subpart
No
Provider details
NPI number
Authorized official
GARY DAWSON (VP OF FINANCE)
(801) 893-2773
Entity
Organization
Contact information
Practice address
12351 S GATEWAY PARK PLACE, SUITE D-500, DRAPER, UT 84020-8402
(269) 998-0866
(801) 683-9907
Mailing address
12351 S GATEWAY PARK PL STE D-700, DRAPER, UT 84020-9581
(801) 893-2773
(801) 683-9907
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02D2195732
CLIA
AK
01
—
46D2209724
CLIA
UT
Enumeration date
10/15/2020
Last updated
03/28/2024
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