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TELLICA IMAGING, LLC
NPI 1407438039
Physiological Laboratory in West Valley City, UT

Active since April 23, 2021
4587 S 4000 W, WEST VALLEY CITY, UT 84120(801) 442-5737 Get Directions Write a Review

NPPES record last updated: January 4, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 4, 2023, Apr 23, 2021 (2 updates tracked since 2021).

About Tellica Imaging, Llc NPPES

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

TELLICA IMAGING, LLC (NPI 1407438039) is a healthcare organization registered as a physiological laboratory in West Valley City, Utah and active in the NPI registry since April 2021. The organization lists Brad Isaacson, Coo, as its authorized official.

NPPES Registry Identity

NPI1407438039
Entity TypeOrganization
Primary Taxonomy293D00000X
Legal Business NameTELLICA IMAGING, LLC
Location Address4587 S 4000 WWest Valley City, UT 84120-6317
Mailing Address36 S State StSalt Lake City, UT 84111-1401
Phone(801) 442-5737
Organization SubpartYesParent: Intermountain Healthcare
Authorized OfficialBrad IsaacsonCoo · (801) 442-5737
Enumeration DateApril 23, 2021
Last NPPES UpdateJanuary 4, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 4, 2023
✔ NPI 1407438039 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysiological LaboratoryLaboratories
Taxonomy Code293D00000X
Definition
A laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.
Also ListedClinic/Center · RadiologyTaxonomy 261QR0200X
4587 S 4000 W, West Valley City, UT 84120
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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 Tellica Imaging, LLC's NPI number?

The NPI number for Tellica Imaging, LLC is 1407438039. It was assigned to this organization in the NPPES registry on April 23, 2021.

Where is Tellica Imaging, LLC located?

Tellica Imaging, LLC is located at 4587 S 4000 W, West Valley City, UT 84120. The listed phone number is (801) 442-5737.

What is Tellica Imaging, LLC's specialty?

The primary specialty registered for this NPI is Physiological Laboratory with taxonomy code 293D00000X.

When was this NPI record last updated?

The NPPES record for Tellica Imaging, LLC was last updated on January 4, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.