46D1031532 CLIA NUMBER - ADVANCED PRACTICE MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 46D1031532
  • Facility Name: ADVANCED PRACTICE MEDICAL CLINIC
  • Facility Address: 491 N MAIN ST
    TOOELE, UT
    ZIP 84074
  • Facility Phone: 435 843-8881
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: BRAND P. REYNOLDS
  • NPI Number: 1548302268
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 46D1031532
LAB Type Practitioner Other
Facility Name ADVANCED PRACTICE MEDICAL CLINIC
Street 491 N MAIN ST
City TOOELE
State UT
ZIP 84074
Phone 435 843-8881
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2024
Certificate Expiration Date 10/3/2026
Facility Type Practitioner Other
Lab Director BRAND P. REYNOLDS

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