46D0980693 CLIA NUMBER - ZION INTERMEDIATE CARE INC - BOUNTIFUL

Laboratory Demographics

CLIA Number: 46D0980693

Facility Name: ZION INTERMEDIATE CARE INC - BOUNTIFUL

Facility Address:
340 N 100 W
BOUNTIFUL, UT
ZIP 84010
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Facility Phone Number: 801 292-6797

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1033118674

Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities
An intermediate care facility providing services for individuals with intellectual disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	46D0980693
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	ZION INTERMEDIATE CARE INC - BOUNTIFUL
Street	340 N 100 W
City	BOUNTIFUL
State	UT
ZIP	84010
Phone	801 292-6797
CertificateType	4
CertificateEffectiveDate	11/30/2022
CertificateExpirationDate	11/29/2024
FacilityType	Waiver

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