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MOUNTAINWEST SURGICAL CENTER LLC
NPI 1124079843
Clinic/Center - Ambulatory Surgical in Bountiful, UT

Active since May 15, 2006CLIA 46D1024014 · Waiver
1551 S RENAISSANCE TOWNE DR, SUITE 200, BOUNTIFUL, UT 84010(801) 383-1111(801) 383-1115 Get Directions Write a Review

NPPES record last updated: October 28, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mountainwest Surgical Center Llc NPPES

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

MOUNTAINWEST SURGICAL CENTER LLC (NPI 1124079843) is a healthcare organization registered as an ambulatory surgical in Bountiful, Utah and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through March 30, 2028 and lists Brian Berg, Administrator, as its authorized official.

NPPES Registry Identity

NPI1124079843
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameMOUNTAINWEST SURGICAL CENTER LLC
Location Address1551 S RENAISSANCE TOWNE DR, SUITE 200Bountiful, UT 84010-7667
Mailing Address1551 Renaissance Towne Dr Ste 200Bountiful, UT 84010-7668 · (801) 383-1111 · Fax (801) 383-1115
Phone(801) 383-1111
Fax(801) 383-1115
Organization SubpartNo
Authorized OfficialBrian BergAdministrator · (801) 383-1111
Enumeration DateMay 15, 2006
Last NPPES UpdateOctober 28, 2009
✔ NPI 1124079843 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
License✔ Licensed in UT · 2006-31532
1551 S RENAISSANCE TOWNE DR, Bountiful, UT 84010
Open in Google Maps ↗

Other Identifiers 2

Medicaid870630186001UT
Medicare PIN000100830UT

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 46D1024014

Mountainwest Surgical Center · Bountiful, UT
Active · expires Mar 30, 2028
CLIA Number46D1024014
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateMarch 31, 2026
Certificate Expiration DateMarch 30, 2028
Laboratory DirectorElise Layne
Laboratory Phone(801) 383-1111
Laboratory LocationMountainwest Surgical Center1551 S Renaissance Towne Dr Ste 200, Bountiful, UT 84010
CLIA data matches this NPI record on: Address Name Phone
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.

ROBERT W JORDAN MD
Orthopaedic Surgery
1551 S RENAISSANCE TOWNE DR, #400
BOUNTIFUL, UT 84010
Davis County (801) 295-7200
MOUNTAIN WEST MEDICINE, INC.
Pharmacy (Community/Retail Pharmacy)
1551 S RENAISSANCE TOWNE DR, SUITE 104
BOUNTIFUL, UT 84010
Davis County (801) 295-6979

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 Mountainwest Surgical Center LLC's NPI number?

The NPI number for Mountainwest Surgical Center LLC is 1124079843. It was assigned to this organization in the NPPES registry on May 15, 2006.

Where is Mountainwest Surgical Center LLC located?

Mountainwest Surgical Center LLC is located at 1551 S Renaissance Towne Dr Suite 200, Bountiful, UT 84010. The listed phone number is (801) 383-1111.

What is Mountainwest Surgical Center LLC's specialty?

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

Does Mountainwest Surgical Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D1024014) is associated with this NPI, valid through March 30, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mountainwest Surgical Center LLC was last updated on October 28, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years 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.