46D0720995 CLIA NUMBER - MT OLYMPUS SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 46D0720995
  • Facility Name: MT OLYMPUS SURGERY CENTER
  • Facility Address: 1250 E 3900 S STE 100
    SALT LAKE CITY, UT
    ZIP 84124
  • Facility Phone: 801 262-0358
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KADEE GOSS
  • NPI Number: 1174587984
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 46D0720995
LAB Type Ambulatory Surgery Center
Facility Name MT OLYMPUS SURGERY CENTER
Street 1250 E 3900 S STE 100
City SALT LAKE CITY
State UT
ZIP 84124
Phone 801 262-0358
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Ambulatory Surgery Center
Lab Director KADEE GOSS

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