| Organization Name: | SLC DIAGNOSTIC IMAGING |
| NPI Number: | 1255769386 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VALERIE LUCKING (OWNER/OPERATOR) |
| Mailing Address: | 6202 W Freedom Hill Way Herriman |
| State: | UT US |
| Postal Code: | 840966987 |
| Phone Number: | 8012536452 |
| Fax Number: | 8012535114 |
| NPI Enumeration Date: | 10/29/2013 |
| NPI Last Update Date: | 10/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM2500X |
| License Number: | 774 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Medical Specialty |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |