46D1031890 CLIA NUMBER - MACEY'S PHARMACY #1058

Laboratory Demographics

  • CLIA Code: 46D1031890
  • Facility Name: MACEY'S PHARMACY #1058
  • Facility Address: 4530 S HIGHLAND DRIVE
    SALT LAKE CITY, UT
    ZIP 84111
  • Facility Phone: 801 278-5388
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICOLETTE MCCARVER
  • NPI Number: 1326371584
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D1031890
LAB Type Pharmacy
Facility Name MACEY'S PHARMACY #1058
Street 4530 S HIGHLAND DRIVE
City SALT LAKE CITY
State UT
ZIP 84111
Phone 801 278-5388
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 NICOLETTE MCCARVER

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