46D0979868 CLIA NUMBER - OPTUM PRIMARY CARE WASATCH PEAK

Laboratory Demographics

  • CLIA Code: 46D0979868
  • Facility Name: OPTUM PRIMARY CARE WASATCH PEAK
  • Facility Address: 1580 W ANTELOPE DRIVE, SUITE 200
    LAYTON, UT
    ZIP 84041
  • Facility Phone: (385) 423-3585
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JEFFERY L. DEGRAUW

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CLIA Record

Field Name Field Value
CLIA Number 46D0979868
LAB Type Physician Office
Facility Name OPTUM PRIMARY CARE WASATCH PEAK
Street 1580 W ANTELOPE DRIVE, SUITE 200
City LAYTON
State UT
ZIP 84041
Phone 3854233585
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 4/4/2026
Certificate Expiration Date 4/3/2028
Facility Type Physician Office
Lab Director JEFFERY L. DEGRAUW

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This page was last updated on: 5/18/2026