URBAN INDIAN CENTER OF SALT LAKE
NPI 1073478855
Pharmacy - Clinic Pharmacy in Salt Lake City, UT

Active since December 23, 2025CLIA 46D1057369 · Waiver
5450 S GREEN ST STE A, SALT LAKE CITY, UT 84123(801) 486-4877 Get Directions Write a Review

NPPES record last updated: December 23, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Urban Indian Center Of Salt Lake NPPES

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

URBAN INDIAN CENTER OF SALT LAKE (NPI 1073478855) is a healthcare organization registered as a clinic pharmacy in Salt Lake City, Utah and active in the NPI registry since December 2025. The organization holds a CLIA Waiver certificate valid through August 9, 2026 and lists William Matthew Poss, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1073478855
Entity TypeOrganization
Primary Taxonomy3336C0002X
Legal Business NameURBAN INDIAN CENTER OF SALT LAKE
Location Address5450 S GREEN ST STE ASalt Lake City, UT 84123-5632
Mailing Address120 W 1300 SSalt Lake City, UT 84115-5230 · (801) 486-4877
Organization SubpartNo
Authorized OfficialWilliam Matthew PossExecutive Director · (858) 204-2039
Enumeration DateDecember 23, 2025
NPPES CertifiedDecember 23, 2025
NPI 1073478855 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacy · Clinic PharmacySuppliers
Taxonomy Code3336C0002X
Definition

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.

5450 S GREEN ST STE A, Salt Lake City, UT 84123

Other Identifiers 1

Medicaid17666UT

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 46D1057369

Urban Indian Center Of Salt Lake · Murray, UT
Active · expires Aug 9, 2026
CLIA Number46D1057369
Laboratory TypeOther
Certificate Effective DateAugust 10, 2024
Certificate Expiration DateAugust 9, 2026
Laboratory DirectorVicky Suruky
Laboratory Phone(801) 486-4877
Laboratory LocationUrban Indian Center Of Salt Lake5450 S Green St, Murray, UT 84123
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

Family Medicine
5450 S GREEN ST STE A
MURRAY, UT 84123
Nurse Practitioner (Gerontology)
5450 S GREEN ST STE A
MURRAY, UT 84123
Dietitian, Registered
5450 S GREEN ST STE A
MURRAY, UT 84123

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 Urban Indian Center Of Salt Lake's NPI number?

The NPI number for Urban Indian Center Of Salt Lake is 1073478855. It was assigned to this organization in the NPPES registry on December 23, 2025.

Where is Urban Indian Center Of Salt Lake located?

Urban Indian Center Of Salt Lake is located at 5450 S Green St Ste A, Salt Lake City, UT 84123. The listed phone number is (801) 486-4877.

What is Urban Indian Center Of Salt Lake's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Clinic Pharmacy, with taxonomy code 3336C0002X.

Does Urban Indian Center Of Salt Lake hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D1057369) is associated with this NPI, valid through August 9, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Urban Indian Center Of Salt Lake was last updated on December 23, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.