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WASATCH OPTIMAL WELLNESS CLINIC LLC
NPI 1508619040
Clinic/Center - Health Service in Heber City, UT

Active since April 05, 2024
1716 N HIGHWAY 40 STE 200, HEBER CITY, UT 84032(435) 800-6969 Get Directions Write a Review

NPPES record last updated: September 22, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: May 6, 2024, Apr 5, 2024 (2 updates tracked since 2024).

About Wasatch Optimal Wellness Clinic Llc NPPES

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

WASATCH OPTIMAL WELLNESS CLINIC LLC (NPI 1508619040), doing business as Wow Clinic, is a healthcare organization registered as a health service in Heber City, Utah and active in the NPI registry since April 2024. The organization lists Benjamin Fogg, Medical Director / Coo, as its authorized official.

NPPES Registry Identity

NPI1508619040
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NameWASATCH OPTIMAL WELLNESS CLINIC LLC
Location Address1716 N HIGHWAY 40 STE 200Heber City, UT 84032-4677
Mailing Address1716 N Highway 40 Ste 200Heber City, UT 84032-4677 · (435) 800-6969
Phone(435) 800-6969
Organization SubpartNo
Authorized OfficialBenjamin FoggMedical Director / Coo · (435) 800-6969
Enumeration DateApril 5, 2024
Last NPPES UpdateSeptember 22, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 22, 2025
✔ NPI 1508619040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
1716 N HIGHWAY 40 STE 200, Heber City, UT 84032
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Other Names 1

Doing Business AsWow Clinic

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 46D2307666

Wasatch Optimal Wellness Clinic, LLC · Heber City, UT
Expired · Jul 11, 2026
CLIA Number46D2307666
Laboratory TypeCommunity Clinic
Certificate Effective DateJuly 12, 2024
Certificate Expiration DateJuly 11, 2026
Laboratory DirectorBenjamin Fogg
Laboratory Phone(435) 800-6969
Laboratory LocationWasatch Optimal Wellness Clinic, LLC1716 N Highway 40, Suite 200, Heber City, UT 84032
CLIA data matches this NPI record on: Address Name Phone
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 Wasatch Optimal Wellness Clinic LLC's NPI number?

The NPI number for Wasatch Optimal Wellness Clinic LLC is 1508619040. It was assigned to this organization in the NPPES registry on April 5, 2024. The provider is doing business as WOW Clinic.

Where is Wasatch Optimal Wellness Clinic LLC located?

Wasatch Optimal Wellness Clinic LLC is located at 1716 N Highway 40 Ste 200, Heber City, UT 84032. The listed phone number is (435) 800-6969.

What is Wasatch Optimal Wellness Clinic LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

When was this NPI record last updated?

The NPPES record for Wasatch Optimal Wellness Clinic LLC was last updated on September 22, 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.