46D0945670 CLIA NUMBER - HERITAGE RESIDENTIAL TREATMENT CENTER

Laboratory Demographics

  • CLIA Code: 46D0945670
  • Facility Name: HERITAGE RESIDENTIAL TREATMENT CENTER
  • Facility Address: 5600 N HERITAGE SCHOOL DR ATTN NURSING
    PROVO, UT
    ZIP 84604
  • Facility Phone: 801 226-4600
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: JAMIS LEEPER
  • NPI Number: 1578699468
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 46D0945670
LAB Type Other
Facility Name HERITAGE RESIDENTIAL TREATMENT CENTER
Street 5600 N HERITAGE SCHOOL DR ATTN NURSING
City PROVO
State UT
ZIP 84604
Phone 801 226-4600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/6/2024
Certificate Expiration Date 5/5/2026
Facility Type Other
Lab Director JAMIS LEEPER

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