46D1026482 CLIA NUMBER - SOUTH MOUNTAIN DIALYSIS LLC

Laboratory Demographics

  • CLIA Code: 46D1026482
  • Facility Name: SOUTH MOUNTAIN DIALYSIS LLC
  • Facility Address: 10969 S RIVERFRONT PARKWAY STE 100
    SOUTH JORDAN, UT
    ZIP 84095
  • Facility Phone: 801 253-9696
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RUTH INDAHYUNG
  • NPI Number: 1033159488
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 46D1026482
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SOUTH MOUNTAIN DIALYSIS LLC
Street 10969 S RIVERFRONT PARKWAY STE 100
City SOUTH JORDAN
State UT
ZIP 84095
Phone 801 253-9696
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2024
Certificate Expiration Date 6/6/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RUTH INDAHYUNG

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