46D0683172 CLIA NUMBER - UTAH STATE DEVELOPMENTAL CENTER

Laboratory Demographics

  • CLIA Code: 46D0683172
  • Facility Name: UTAH STATE DEVELOPMENTAL CENTER
  • Facility Address: 895 N 900 E
    AM FORK, UT
    ZIP 84003
  • Facility Phone: 801 763-4000
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Microscopy
  • Lab Director: STEVEN D. MONSON
  • NPI Number: 1689674301
  • Taxonomy: 310500000X - Intermediate Care Facility, Mental Illness

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 46D0683172
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name UTAH STATE DEVELOPMENTAL CENTER
Street 895 N 900 E
City AM FORK
State UT
ZIP 84003
Phone 801 763-4000
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 9/4/2025
Certificate Expiration Date 9/3/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director STEVEN D. MONSON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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