46D1024970 CLIA NUMBER - MEDALLUS MEDICAL

Laboratory Demographics

  • CLIA Code: 46D1024970
  • Facility Name: MEDALLUS MEDICAL
  • Facility Address: 10433 S REDWOOD RD
    SOUTH JORDAN, UT
    ZIP 84095
  • Facility Phone: 801 260-1919
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LISA ANDERSON
  • NPI Number: 1902329469
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 46D1024970
LAB Type Physician Office
Facility Name MEDALLUS MEDICAL
Street 10433 S REDWOOD RD
City SOUTH JORDAN
State UT
ZIP 84095
Phone 801 260-1919
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 4/26/2024
Certificate Expiration Date 4/25/2026
Facility Type Physician Office
Lab Director LISA ANDERSON

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