46D1031848 CLIA NUMBER - FRESH MARKET PHARMACY #2312

Laboratory Demographics

  • CLIA Code: 46D1031848
  • Facility Name: FRESH MARKET PHARMACY #2312
  • Facility Address: 560 W CENTER ST
    PROVO, UT
    ZIP 84601
  • Facility Phone: 801 374-1704
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAUL THOMPSON
  • NPI Number: 1427381714
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D1031848
LAB Type Pharmacy
Facility Name FRESH MARKET PHARMACY #2312
Street 560 W CENTER ST
City PROVO
State UT
ZIP 84601
Phone 801 374-1704
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type Pharmacy
Lab Director PAUL THOMPSON

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