46D0947397 CLIA NUMBER - HIDDEN VALLEY FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 46D0947397

Facility Name: HIDDEN VALLEY FAMILY MEDICINE

Facility Address:
12176 SOUTH 1000 EAST
DRAPER, UT
ZIP 84020
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Facility Phone Number: 801 572-3750

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1144246984

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	46D0947397
LAB Type	Physician Office
Facility Name	HIDDEN VALLEY FAMILY MEDICINE
Street	12176 SOUTH 1000 EAST
City	DRAPER
State	UT
ZIP	84020
Phone	801 572-3750
CertificateType	4
CertificateEffectiveDate	6/15/2022
CertificateExpirationDate	6/14/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024