46D1035987 CLIA NUMBER - MACEY'S PHARMACY #8

Laboratory Demographics

  • CLIA Code: 46D1035987
  • Facility Name: MACEY'S PHARMACY #8
  • Facility Address: 50 NORTH HIGHWAY 165 ATTN PHARMACY MANAGER
    PROVIDENCE, UT
    ZIP 84332
  • Facility Phone: 435 752-1111
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THOMAS KEELE
  • NPI Number: 1558495457
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D1035987
LAB Type Pharmacy
Facility Name MACEY'S PHARMACY #8
Street 50 NORTH HIGHWAY 165 ATTN PHARMACY MANAGER
City PROVIDENCE
State UT
ZIP 84332
Phone 435 752-1111
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 THOMAS KEELE

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