46D1050935 CLIA NUMBER - UTAH LUNG CENTER LLC

Laboratory Demographics

  • CLIA Code: 46D1050935
  • Facility Name: UTAH LUNG CENTER LLC
  • Facility Address: 3584 WEST 9000 SOUTH STE 201
    WEST JORDAN, UT
    ZIP 84088
  • Facility Phone: 801 562-5864
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IMAD S. FARRUKH
  • NPI Number: 1093923591
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 46D1050935
LAB Type Physician Office
Facility Name UTAH LUNG CENTER LLC
Street 3584 WEST 9000 SOUTH STE 201
City WEST JORDAN
State UT
ZIP 84088
Phone 801 562-5864
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2024
Certificate Expiration Date 2/14/2026
Facility Type Physician Office
Lab Director IMAD S. FARRUKH

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