46D1027928 CLIA NUMBER - GRANGER MEDICAL CLINIC / LAB

Laboratory Demographics

CLIA Number: 46D1027928

Facility Name: GRANGER MEDICAL CLINIC / LAB

Facility Address:
7181 S CAMPUS VIEW DRIVE
WEST JORDAN, UT
ZIP 84084
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Facility Phone Number: 801 965-3482

Facility Type: Practitioner Other

Certificate Type: Accreditation

NPI Number: 1093330698

Taxonomy: 332900000X - Non-Pharmacy Dispensing Site
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

CLIA Record

Field Name	Field Value
CLIA Number	46D1027928
LAB Type	Practitioner Other
Facility Name	GRANGER MEDICAL CLINIC / LAB
Street	7181 S CAMPUS VIEW DRIVE
City	WEST JORDAN
State	UT
ZIP	84084
Phone	801 965-3482
CertificateType	1
CertificateEffectiveDate	2/6/2023
CertificateExpirationDate	2/5/2025
FacilityType	Accreditation

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