46D1031891 CLIA NUMBER - FRESH MARKET PHARMACY #2365

Laboratory Demographics

  • CLIA Code: 46D1031891
  • Facility Name: FRESH MARKET PHARMACY #2365
  • Facility Address: 1760 PARK AVENUE
    PARK CITY, UT
    ZIP 84060
  • Facility Phone: 435 649-6264
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES DIX
  • NPI Number: 1811221047
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D1031891
LAB Type Pharmacy
Facility Name FRESH MARKET PHARMACY #2365
Street 1760 PARK AVENUE
City PARK CITY
State UT
ZIP 84060
Phone 435 649-6264
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 JAMES DIX

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