46D0916696 CLIA NUMBER - INTERMOUNTAIN SPINE INSTITUTE

Laboratory Demographics

  • CLIA Code: 46D0916696
  • Facility Name: INTERMOUNTAIN SPINE INSTITUTE
  • Facility Address: 5770 S 250 E STE 135
    SALT LAKE CITY, UT
    ZIP 84107
  • Facility Phone: 801 314-2225
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOYCE MCNEILL
  • NPI Number: 1821458878
  • Taxonomy: 207XS0117X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 46D0916696
LAB Type Physician Office
Facility Name INTERMOUNTAIN SPINE INSTITUTE
Street 5770 S 250 E STE 135
City SALT LAKE CITY
State UT
ZIP 84107
Phone 801 314-2225
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/28/2024
Certificate Expiration Date 6/27/2026
Facility Type Physician Office
Lab Director JOYCE MCNEILL

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