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PREMISE HEALTH OF UTAH MEDICAL PC
NPI 1063986800
Clinic/Center - Multi-Specialty in West Valley City, UT

Active since January 15, 2019CLIA Certified · 2 labs
4163 S 3200 W, WEST VALLEY CITY, UT 84119(801) 964-9355(801) 967-2692 Get Directions Write a Review

NPPES record last updated: January 29, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 29, 2026, Aug 24, 2022, Mar 9, 2021 and 1 more (4 updates tracked since 2019).

About Premise Health Of Utah Medical Pc NPPES

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

PREMISE HEALTH OF UTAH MEDICAL PC (NPI 1063986800), doing business as Granite Wellness Center, is a healthcare organization registered as a multi-specialty in West Valley City, Utah and active in the NPI registry since January 2019. The organization holds 2 active CLIA laboratory certificates and lists Edward William Schwartz, President, as its authorized official.

NPPES Registry Identity

NPI1063986800
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NamePREMISE HEALTH OF UTAH MEDICAL PC
Location Address4163 S 3200 WWest Valley City, UT 84119-5128
Mailing Address5500 Maryland Way Ste 120Brentwood, TN 37027-4993
Phone(801) 964-9355
Fax(801) 967-2692
Organization SubpartNo
Authorized OfficialEdward William SchwartzPresident · (844) 407-7557
Enumeration DateJanuary 15, 2019
Last NPPES UpdateJanuary 29, 20264 updates tracked since enumeration
NPPES CertifiedJanuary 29, 2026
✔ NPI 1063986800 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
4163 S 3200 W, West Valley City, UT 84119
Open in Google Maps ↗

Other Names 1

Doing Business AsGranite Wellness Center

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

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 of Waiver 46D2161974

Premise Health Of Utah Medical, PC · West Valley City, UT
Active · expires Feb 12, 2027
CLIA Number46D2161974
Laboratory TypePhysician Office
Certificate Effective DateFebruary 13, 2025
Certificate Expiration DateFebruary 12, 2027
Laboratory DirectorAllen Francis
Laboratory Phone(801) 964-9355
Laboratory LocationPremise Health Of Utah Medical, PC4163 South 3200 West, West Valley City, UT 84119
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 46D2117266

Premise Health Of Utah Medical, PC · West Valley City, UT
Active · expires Aug 11, 2026
CLIA Number46D2117266
Laboratory TypePhysician Office
Certificate Effective DateAugust 12, 2024
Certificate Expiration DateAugust 11, 2026
Laboratory DirectorAbigail Webster
Laboratory Phone(801) 823-5838
Laboratory LocationPremise Health Of Utah Medical, PC2300 South 2300 West, Ste B, West Valley City, UT 84119
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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 Premise Health Of Utah Medical PC's NPI number?

The NPI number for Premise Health Of Utah Medical PC is 1063986800. It was assigned to this organization in the NPPES registry on January 15, 2019. The provider is doing business as Granite Wellness Center.

Where is Premise Health Of Utah Medical PC located?

Premise Health Of Utah Medical PC is located at 4163 S 3200 W, West Valley City, UT 84119. The listed phone number is (801) 964-9355.

What is Premise Health Of Utah Medical PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Premise Health Of Utah Medical PC 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.

What insurance does Premise Health Of Utah Medical PC accept?

Health plans from Blue Cross Blue Shield of North Dakota, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Premise Health Of Utah Medical PC 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 Premise Health Of Utah Medical PC was last updated on January 29, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.