46D0522876 CLIA NUMBER - INTERMOUNTAIN CENTRAL OREM CLINIC

Laboratory Demographics

CLIA Number: 46D0522876

Facility Name: INTERMOUNTAIN CENTRAL OREM CLINIC

Facility Address:
505 W 400 N
OREM, UT
ZIP 84057
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Facility Phone Number: 801 714-3450

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1942336649

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	46D0522876
LAB Type	Physician Office
Facility Name	INTERMOUNTAIN CENTRAL OREM CLINIC
Street	505 W 400 N
City	OREM
State	UT
ZIP	84057
Phone	801 714-3450
CertificateType	3
CertificateEffectiveDate	5/5/2024
CertificateExpirationDate	5/4/2026
FacilityType	PPMP

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This page was last updated on: 4/23/2024