46D0872668 CLIA NUMBER - PROVIDENCE FAMILY MEDICINE OGDEN CLINIC

Laboratory Demographics

  • CLIA Code: 46D0872668
  • Facility Name: PROVIDENCE FAMILY MEDICINE OGDEN CLINIC
  • Facility Address: 382 W 280 N
    PROVIDENCE, UT
    ZIP 84332
  • Facility Phone: 435 752-0330
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MELANIE L. RICHARDS
  • NPI Number: 1598390494
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 46D0872668
LAB Type Physician Office
Facility Name PROVIDENCE FAMILY MEDICINE OGDEN CLINIC
Street 382 W 280 N
City PROVIDENCE
State UT
ZIP 84332
Phone 435 752-0330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2025
Certificate Expiration Date 7/31/2027
Facility Type Physician Office
Lab Director MELANIE L. RICHARDS

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