46D0525587 CLIA NUMBER - INTERMOUNTAIN FILLMORE CLINIC

Laboratory Demographics

  • CLIA Code: 46D0525587
  • Facility Name: INTERMOUNTAIN FILLMORE CLINIC
  • Facility Address: 700 S HWY 99
    FILLMORE, UT
    ZIP 84631
  • Facility Phone: 435 218-8909
  • Facility Type: Other - CLINIC
  • Facility Type: Waiver
  • Lab Director: CHAD SELLER
  • NPI Number: 1023159381
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 46D0525587
LAB Type Other - CLINIC
Facility Name INTERMOUNTAIN FILLMORE CLINIC
Street 700 S HWY 99
City FILLMORE
State UT
ZIP 84631
Phone 435 218-8909
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2025
Certificate Expiration Date 9/15/2027
Facility Type Other - CLINIC
Lab Director CHAD SELLER

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