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GRANGER MEDICAL CLINIC PC
NPI 1104857549
Clinic/Center - Multi-Specialty in West Jordan, UT

Active since July 05, 2006CLIA Certified · 3 labs
3181 W 9000 SO, WEST JORDAN, UT 84088(801) 352-5900(801) 352-5914 Get Directions Write a Review

NPPES record last updated: September 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 2, 2025, Nov 19, 2024, Dec 13, 2023 (3 updates tracked since 2023).

About Granger Medical Clinic Pc NPPES

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

GRANGER MEDICAL CLINIC PC (NPI 1104857549), doing business as Granger Medical West Jordan, is a healthcare organization registered as a multi-specialty in West Jordan, Utah and active in the NPI registry since July 2006. The organization holds 3 active CLIA laboratory certificates and lists Mary Jane Pennington, President, as its authorized official.

NPPES Registry Identity

NPI1104857549
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameGRANGER MEDICAL CLINIC PC
Location Address3181 W 9000 SOWest Jordan, UT 84088
Mailing Address2965 W 3500 SWest Valley City, UT 84119-3602 · (801) 965-3600
Phone(801) 352-5900
Fax(801) 352-5914
Organization SubpartYes
Authorized OfficialMary Jane PenningtonPresident · (801) 965-3600
Enumeration DateJuly 5, 2006
Last NPPES UpdateSeptember 2, 20253 updates tracked since enumeration
NPPES CertifiedNovember 19, 2024
✔ NPI 1104857549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
3181 W 9000 SO, West Jordan, UT 84088
Open in Google Maps ↗

Other Names 1

Doing Business AsGranger Medical West Jordan

CLIA Laboratory Certificates CMS CLIA 3

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) 46D0669065

Granger Medical West Jordan Clinic · West Jordan, UT
Active · expires Mar 20, 2028
CLIA Number46D0669065
Laboratory TypePhysician Office
Certificate Effective DateMarch 21, 2026
Certificate Expiration DateMarch 20, 2028
Laboratory DirectorBrandon Allen
Laboratory Phone(801) 569-5600
Laboratory LocationGranger Medical West Jordan Clinic3181 W 9000 S, West Jordan, UT 84088
CLIA data matches this NPI record on: Address Name
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 Compliance 46D2013546

Granger Medical Clinic Dermatology · West Jordan, UT
Active · expires Mar 22, 2027
CLIA Number46D2013546
Laboratory TypePhysician Office
Certificate Effective DateMarch 23, 2025
Certificate Expiration DateMarch 22, 2027
Laboratory DirectorDr. Douglas Heiner
Laboratory Phone(801) 965-2799
Laboratory LocationGranger Medical Clinic Dermatology9001 S 3200 W, Unit 2, West Jordan, UT 84088
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 46D2316064

Granger Medical Clinic Pain And Spine, West Jordan · West Jordan, UT
Active · expires Dec 26, 2026
CLIA Number46D2316064
Laboratory TypePhysician Office
Certificate Effective DateDecember 27, 2024
Certificate Expiration DateDecember 26, 2026
Laboratory DirectorAshleigh Byrne
Laboratory Phone(801) 569-5547
Laboratory LocationGranger Medical Clinic Pain And Spine, West Jordan9001 S 3200 W, Bldg B, Ste 3, West Jordan, UT 84088
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.

GRANGER MEDICAL PARK CITY
Clinic/Center (Multi-Specialty)
3181 W 9000 SO
WEST JORDAN, UT 84088
Salt Lake County (801) 569-5520
SANDEEP CHOWDHARY MD
Internal Medicine (Pulmonary Disease)
3181 W 9000 SO
WEST JORDAN, UT 84088
Salt Lake County (801) 352-5900

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 Granger Medical Clinic PC's NPI number?

The NPI number for Granger Medical Clinic PC is 1104857549. It was assigned to this organization in the NPPES registry on July 5, 2006. The provider is doing business as Granger Medical West Jordan.

Where is Granger Medical Clinic PC located?

Granger Medical Clinic PC is located at 3181 W 9000 So, West Jordan, UT 84088. The listed phone number is (801) 352-5900.

What is Granger Medical Clinic PC's specialty?

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

Does Granger Medical Clinic PC hold CLIA laboratory certificates?

Yes. 3 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 Granger Medical Clinic PC was last updated on September 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.