46D0705763 CLIA NUMBER - SUMMIT COUNTY PUBLIC HEALTH DEPARTMENT

Laboratory Demographics

  • CLIA Code: 46D0705763
  • Facility Name: SUMMIT COUNTY PUBLIC HEALTH DEPARTMENT
  • Facility Address: 650 ROUND VALLEY DR
    PARK CITY, UT
    ZIP 84060
  • Facility Phone: 435 333-1504
  • Facility Type: Other - COUNTY HEALTH DEPARTMENT
  • Facility Type: Microscopy
  • Lab Director: DEREK B. MOSS
  • NPI Number: 1902456148
  • Taxonomy: 171M00000X - Case Manager/Care Coordinator

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CLIA Record

Field Name Field Value
CLIA Number 46D0705763
LAB Type Other - COUNTY HEALTH DEPARTMENT
Facility Name SUMMIT COUNTY PUBLIC HEALTH DEPARTMENT
Street 650 ROUND VALLEY DR
City PARK CITY
State UT
ZIP 84060
Phone 435 333-1504
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 12/15/2024
Certificate Expiration Date 12/14/2026
Facility Type Other - COUNTY HEALTH DEPARTMENT
Lab Director DEREK B. MOSS

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