46D1031999 CLIA NUMBER - MACEY'S, INC #1062

Laboratory Demographics

  • CLIA Code: 46D1031999
  • Facility Name: MACEY'S, INC #1062
  • Facility Address: 5632 S 900 E
    SALT LAKE CITY, UT
    ZIP 84121
  • Facility Phone: 801 262-1025
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERIC D. MATHEWS
  • NPI Number: 1356674667
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D1031999
LAB Type Pharmacy
Facility Name MACEY'S, INC #1062
Street 5632 S 900 E
City SALT LAKE CITY
State UT
ZIP 84121
Phone 801 262-1025
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2024
Certificate Expiration Date 12/21/2026
Facility Type Pharmacy
Lab Director ERIC D. MATHEWS

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