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46D0524216 CLIA NUMBER - INTERMOUNTAIN HOLLADAY CLINIC

Laboratory Demographics

CLIA Number: 46D0524216

Facility Name: INTERMOUNTAIN HOLLADAY CLINIC

Facility Address:
6272 S HIGHLAND DR
MURRAY, UT
ZIP 84121
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Facility Phone Number: 801 871-6127

Facility Type: Other - CLINIC

Certificate Type: Certificate of Compliance
NPI Number: 1528037264

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 46D0524216
LAB Type Other - CLINIC
Facility Name INTERMOUNTAIN HOLLADAY CLINIC
Street 6272 S HIGHLAND DR
City MURRAY
State UT
ZIP 84121
Phone 801 871-6127
CertificateType 2
CertificateEffectiveDate 4/6/2022
CertificateExpirationDate 4/30/2024
FacilityType Compliance

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