46D1027928 CLIA NUMBER - GRANGER MEDICAL CLINIC / LAB

Laboratory Demographics

  • CLIA Code: 46D1027928
  • Facility Name: GRANGER MEDICAL CLINIC / LAB
  • Facility Address: 995 W LEVOY DR
    SALT LAKE CITY, UT
    ZIP 84123
  • Facility Phone: 801 965-3482
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. BRIAN KELLY
  • NPI Number: 1093330698
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 46D1027928
LAB Type Physician Office
Facility Name GRANGER MEDICAL CLINIC / LAB
Street 995 W LEVOY DR
City SALT LAKE CITY
State UT
ZIP 84123
Phone 801 965-3482
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 2/6/2025
Certificate Expiration Date 2/5/2027
Facility Type Physician Office
Lab Director DR. BRIAN KELLY

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