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OLYMPUS FAMILY MEDICINE
NPI 1053764431
Clinic/Center - Primary Care in Salt Lake City, UT

Active since July 20, 2016CLIA Certified · 2 labs
4624 S HOLLADAY BLVD STE 100, SALT LAKE CITY, UT 84117(801) 277-2682 Get Directions Write a Review

NPPES record last updated: July 20, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Olympus Family Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLYMPUS FAMILY MEDICINE (NPI 1053764431) is a healthcare organization registered as a primary care in Salt Lake City, Utah and active in the NPI registry since July 2016. The organization holds 2 active CLIA laboratory certificates and lists Jared Probst, President, as its authorized official.

NPPES Registry Identity

NPI1053764431
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameOLYMPUS FAMILY MEDICINE
Location Address4624 S HOLLADAY BLVD STE 100Salt Lake City, UT 84117-7054
Mailing Address4624 S Holladay Blvd Ste 100Salt Lake City, UT 84117-7054 · (801) 277-2682
Phone(801) 277-2682
Organization SubpartNo
Authorized OfficialJared ProbstPresident · (801) 277-2682
Enumeration DateJuly 20, 2016
✔ NPI 1053764431 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in UT · 98642974405
4624 S HOLLADAY BLVD STE 100, Salt Lake City, UT 84117
Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 46D0524274

Olympus Family Medicine · Holladay, UT
Active · expires May 31, 2027
CLIA Number46D0524274
Laboratory TypePhysician Office
Certificate Effective DateJune 1, 2025
Certificate Expiration DateMay 31, 2027
Laboratory DirectorKristen Romo
Laboratory Phone(801) 277-2682
Laboratory LocationOlympus Family Medicine4624 S Holladay Blvd Suite 100 Attention Christine Krispinsky, Holladay, UT 84117
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 46D2143919

Olympus Family Medicine/Cct Research · Salt Lake City, UT
Active · expires Feb 6, 2028
CLIA Number46D2143919
Laboratory TypeResearch Clinic
Certificate Effective DateFebruary 7, 2026
Certificate Expiration DateFebruary 6, 2028
Laboratory DirectorJared Probst
Laboratory Phone(801) 716-8160
Laboratory LocationOlympus Family Medicine/Cct Research4624 Holladay Blvd E Suite 1, Salt Lake City, UT 84117
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHANNON WILKES QUINN APRN
Nurse Practitioner (Family)
4624 S HOLLADAY BLVD STE 100
SALT LAKE CITY, UT 84117
Salt Lake County (801) 277-2682
CATHERINE COATES A.P.R.N.
Nurse Practitioner (Primary Care)
4624 S HOLLADAY BLVD STE 100
SALT LAKE CITY, UT 84117
Salt Lake County (801) 277-2682

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Olympus Family Medicine's NPI number?

The NPI number for Olympus Family Medicine is 1053764431. It was assigned to this organization in the NPPES registry on July 20, 2016.

Where is Olympus Family Medicine located?

Olympus Family Medicine is located at 4624 S Holladay Blvd Ste 100, Salt Lake City, UT 84117. The listed phone number is (801) 277-2682.

What is Olympus Family Medicine's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Olympus Family Medicine hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Olympus Family Medicine was last updated on July 20, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.