46D0723939 CLIA NUMBER - INTERMOUNTAIN SOUTH JORDAN CLINIC

Laboratory Demographics

  • CLIA Code: 46D0723939
  • Facility Name: INTERMOUNTAIN SOUTH JORDAN CLINIC
  • Facility Address: 11444 S REDWOOD RD
    SOUTH JORDAN, UT
    ZIP 84095
  • Facility Phone: 801 253-5900
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: PATRICK MARCROFT
  • NPI Number: 1609973643
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 46D0723939
LAB Type Community Clinic
Facility Name INTERMOUNTAIN SOUTH JORDAN CLINIC
Street 11444 S REDWOOD RD
City SOUTH JORDAN
State UT
ZIP 84095
Phone 801 253-5900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/16/2025
Certificate Expiration Date 3/15/2027
Facility Type Community Clinic
Lab Director PATRICK MARCROFT

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