46D1042547 CLIA NUMBER - ALPINE PLASTIC & RECONSTRUCTIVE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 46D1042547
  • Facility Name: ALPINE PLASTIC & RECONSTRUCTIVE SURGERY CENTER
  • Facility Address: 5405 SOUTH 500 EAST SUITE 101
    OGDEN, UT
    ZIP 84405
  • Facility Phone: 801 689-3505
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RANDALL BARNETT
  • NPI Number: 1013121003
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 46D1042547
LAB Type Ambulatory Surgery Center
Facility Name ALPINE PLASTIC & RECONSTRUCTIVE SURGERY CENTER
Street 5405 SOUTH 500 EAST SUITE 101
City OGDEN
State UT
ZIP 84405
Phone 801 689-3505
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2025
Certificate Expiration Date 6/30/2027
Facility Type Ambulatory Surgery Center
Lab Director RANDALL BARNETT

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