46D0716310 CLIA NUMBER - JON W AHLSTROM MD, PC

Laboratory Demographics

  • CLIA Code: 46D0716310
  • Facility Name: JON W AHLSTROM MD, PC
  • Facility Address: 550 EAST 1400 NORTH #I
    LOGAN, UT
    ZIP 84341
  • Facility Phone: 801 753-1545
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JOHN W. AHLSTROM
  • NPI Number: 1437146065
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 46D0716310
LAB Type Physician Office
Facility Name JON W AHLSTROM MD, PC
Street 550 EAST 1400 NORTH #I
City LOGAN
State UT
ZIP 84341
Phone 801 753-1545
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 JOHN W. AHLSTROM

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