46D1004961 CLIA NUMBER - INTERMOUNTAIN ALTA VIEW CLINIC

Laboratory Demographics

CLIA Number: 46D1004961

Facility Name: INTERMOUNTAIN ALTA VIEW CLINIC

Facility Address:
9450 S 1300 E
SANDY, UT
ZIP 84094
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Facility Phone Number: 801 523-2483

Facility Type: Other - INSTACARE

Certificate Type: Certificate of Compliance

NPI Number: 1447367164

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	46D1004961
LAB Type	Other - INSTACARE
Facility Name	INTERMOUNTAIN ALTA VIEW CLINIC
Street	9450 S 1300 E
City	SANDY
State	UT
ZIP	84094
Phone	801 523-2483
CertificateType	2
CertificateEffectiveDate	11/10/2023
CertificateExpirationDate	11/9/2025
FacilityType	Compliance

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