46D0955983 CLIA NUMBER - JOLLEY'S COMPOUNDING PHARMACY

Laboratory Demographics

  • CLIA Code: 46D0955983
  • Facility Name: JOLLEY'S COMPOUNDING PHARMACY
  • Facility Address: 1702 S 1100 E
    SALT LAKE CITY, UT
    ZIP 84105
  • Facility Phone: 801 484-4393
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEAN JOLLEY
  • NPI Number: 1659445187
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D0955983
LAB Type Pharmacy
Facility Name JOLLEY'S COMPOUNDING PHARMACY
Street 1702 S 1100 E
City SALT LAKE CITY
State UT
ZIP 84105
Phone 801 484-4393
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2023
Certificate Expiration Date 10/1/2025
Facility Type Pharmacy
Lab Director DEAN JOLLEY

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