46D1047543 CLIA NUMBER - ASHLEY VALLEY FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 46D1047543
  • Facility Name: ASHLEY VALLEY FAMILY PRACTICE
  • Facility Address: 872 W US 40
    VERNAL, UT
    ZIP 84078
  • Facility Phone: 435 781-8899
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MACKENZIE C. ANDERTON
  • NPI Number: 1881779809
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 46D1047543
LAB Type Physician Office
Facility Name ASHLEY VALLEY FAMILY PRACTICE
Street 872 W US 40
City VERNAL
State UT
ZIP 84078
Phone 435 781-8899
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2023
Certificate Expiration Date 11/7/2025
Facility Type Physician Office
Lab Director MACKENZIE C. ANDERTON

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