46D0523647 CLIA NUMBER - MIDTOWN MANOR

Laboratory Demographics

  • CLIA Code: 46D0523647
  • Facility Name: MIDTOWN MANOR
  • Facility Address: 125 S 900 W
    SALT LAKE CITY, UT
    ZIP 84104
  • Facility Phone: 801 363-6340
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CLARINE MOFFITT
  • NPI Number: 1962645507
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 46D0523647
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MIDTOWN MANOR
Street 125 S 900 W
City SALT LAKE CITY
State UT
ZIP 84104
Phone 801 363-6340
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CLARINE MOFFITT

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This page was last updated on: 6/4/2025