46D1035978 CLIA NUMBER - MACEY'S INC #0962

Laboratory Demographics

  • CLIA Code: 46D1035978
  • Facility Name: MACEY'S INC #0962
  • Facility Address: 3981 WASATCH BOULEVARD
    SALT LAKE CITY, UT
    ZIP 84124
  • Facility Phone: 801 272-9494
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAUNA BURLINGAME
  • NPI Number: 1083723142
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D1035978
LAB Type Pharmacy
Facility Name MACEY'S INC #0962
Street 3981 WASATCH BOULEVARD
City SALT LAKE CITY
State UT
ZIP 84124
Phone 801 272-9494
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2025
Certificate Expiration Date 1/17/2027
Facility Type Pharmacy
Lab Director TAUNA BURLINGAME

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