LOGAN SURGERY CENTER, LLC
NPI 1063082980
Clinic/Center - Ambulatory Surgical in Logan, UT

Active since July 01, 2021CLIA 46D2236698 · Waiver

NPPES record last updated: November 25, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 25, 2025, Oct 21, 2021, Jul 1, 2021 (3 updates tracked since 2021).

About Logan Surgery Center, Llc NPPES

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

LOGAN SURGERY CENTER, LLC (NPI 1063082980), doing business as Intermountain Health Surgery Center - Logan, is a healthcare organization registered as an ambulatory surgical in Logan, Utah and active in the NPI registry since July 2021. The organization holds a CLIA Waiver certificate valid through September 19, 2027 and lists Brandon Mcbride, Administrator, as its authorized official.

NPPES Registry Identity

NPI1063082980
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameLOGAN SURGERY CENTER, LLC
Location Address1350 N 500 ELogan, UT 84341-2400
Mailing Address1350 N 500 ELogan, UT 84341-2400 · (435) 363-9265
Organization SubpartNo
Authorized OfficialBrandon McbrideAdministrator · (435) 890-0263
Enumeration DateJuly 1, 2021
Last NPPES UpdateNovember 25, 20253 updates tracked since enumeration
NPPES CertifiedNovember 25, 2025
NPI 1063082980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
1350 N 500 E, Logan, UT 84341

Other Names 2

Doing Business AsIntermountain Health Surgery Center - Logan
Doing Business AsIntermountain Surgery Center - Logan

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

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 of Waiver 46D2236698

Logan Surgery Center, LLC · Logan, UT
Active · expires Sep 19, 2027
CLIA Number46D2236698
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateSeptember 20, 2025
Certificate Expiration DateSeptember 19, 2027
Laboratory DirectorWesley Mortensen
Laboratory Phone(801) 507-9967
Laboratory LocationLogan Surgery Center, LLC1350 North 500 East, Logan, UT 84341
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Imaging of urinary tract following injection of a contrast agent 74420
This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.
20 services19 patients
Crushing of stone of ureter with insertion of stent using an endoscope 52356
This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.
17 services14 patients

Other Providers at the Same Location NPPES 20

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

Obstetrics & Gynecology
1350 N 500 E
LOGAN, UT 84341
Surgery
1350 N 500 E
LOGAN, UT 84341
Pharmacy (Community/Retail Pharmacy)
1350 N 500 E
LOGAN, UT 84341
Physician Assistant
1350 N 500 E
LOGAN, UT 84341
Internal Medicine (Rheumatology)
1350 N 500 E
LOGAN, UT 84341
Internal Medicine
1350 N 500 E
LOGAN, UT 84341
Internal Medicine
1350 N 500 E
LOGAN, UT 84341
Otolaryngology
1350 N 500 E
LOGAN, UT 84341

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 Logan Surgery Center, LLC's NPI number?

The NPI number for Logan Surgery Center, LLC is 1063082980. It was assigned to this organization in the NPPES registry on July 1, 2021. The provider is doing business as Intermountain Health Surgery Center - Logan and Intermountain Surgery Center - Logan.

Where is Logan Surgery Center, LLC located?

Logan Surgery Center, LLC is located at 1350 N 500 E, Logan, UT 84341. The listed phone number is (435) 363-9265.

What is Logan Surgery Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Logan Surgery Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2236698) is associated with this NPI, valid through September 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Logan Surgery Center, LLC accept?

Health plans from Molina Healthcare, Select Health and University of Utah Health Plans list Logan Surgery Center, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Logan Surgery Center, LLC was last updated on November 25, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.