46D0676199 CLIA NUMBER - PRIMARY CARE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 46D0676199
  • Facility Name: PRIMARY CARE PEDIATRICS
  • Facility Address: 2245 N 400 E, SUITE 202
    LOGAN, UT
    ZIP 84341
  • Facility Phone: 435 753-7337
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BARRETT W. LABRUM
  • NPI Number: 1588969539
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 46D0676199
LAB Type Physician Office
Facility Name PRIMARY CARE PEDIATRICS
Street 2245 N 400 E, SUITE 202
City LOGAN
State UT
ZIP 84341
Phone 435 753-7337
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2025
Certificate Expiration Date 8/19/2027
Facility Type Physician Office
Lab Director BARRETT W. LABRUM

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