46D0524399 CLIA NUMBER - EPIPHANY DERMATOLOGY OF UTAH, LLC

Laboratory Demographics

  • CLIA Code: 46D0524399
  • Facility Name: EPIPHANY DERMATOLOGY OF UTAH, LLC
  • Facility Address: 4133 PIONEER PARKWAY SUITE 120
    WEST VALLEY CITY, UT
    ZIP 84120
  • Facility Phone: 801 966-1404
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JESSE D. JENSEN
  • NPI Number: 1215031620
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 46D0524399
LAB Type Physician Office
Facility Name EPIPHANY DERMATOLOGY OF UTAH, LLC
Street 4133 PIONEER PARKWAY SUITE 120
City WEST VALLEY CITY
State UT
ZIP 84120
Phone 801 966-1404
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 5/20/2025
Certificate Expiration Date 5/19/2027
Facility Type Physician Office
Lab Director JESSE D. JENSEN

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This page was last updated on: 9/29/2025