46D0525734 CLIA NUMBER - BEAVER MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 46D0525734
  • Facility Name: BEAVER MEDICAL CLINIC
  • Facility Address: 1059 NORTH 100 W
    BEAVER, UT
    ZIP 84713
  • Facility Phone: 801 438-2426
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LANCE N. SMITH
  • NPI Number: 1336136969
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 46D0525734
LAB Type Physician Office
Facility Name BEAVER MEDICAL CLINIC
Street 1059 NORTH 100 W
City BEAVER
State UT
ZIP 84713
Phone 801 438-2426
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director LANCE N. SMITH

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