46D0954808 CLIA NUMBER - INTERMOUNTAIN MANTI FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 46D0954808
  • Facility Name: INTERMOUNTAIN MANTI FAMILY PRACTICE
  • Facility Address: 159 N MAIN ST
    MANTI, UT
    ZIP 84642
  • Facility Phone: 435 835-3344
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MICHAEL S. FRISCHKNECHT MD
  • NPI Number: 1356485411
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 46D0954808
LAB Type Physician Office
Facility Name INTERMOUNTAIN MANTI FAMILY PRACTICE
Street 159 N MAIN ST
City MANTI
State UT
ZIP 84642
Phone 435 835-3344
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 11/8/2024
Certificate Expiration Date 11/7/2026
Facility Type Physician Office
Lab Director MICHAEL S. FRISCHKNECHT MD

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