46D1056000 CLIA NUMBER - MOUNTAIN MEDICAL IMAGING

Laboratory Demographics

  • CLIA Code: 46D1056000
  • Facility Name: MOUNTAIN MEDICAL IMAGING
  • Facility Address: 5323 S WOODROW ST STE 100
    MURRAY, UT
    ZIP 84107
  • Facility Phone: 801 713-0600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RODNEY JARAMILLO
  • NPI Number: 1033757166
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 46D1056000
LAB Type Physician Office
Facility Name MOUNTAIN MEDICAL IMAGING
Street 5323 S WOODROW ST STE 100
City MURRAY
State UT
ZIP 84107
Phone 801 713-0600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/3/2024
Certificate Expiration Date 7/2/2026
Facility Type Physician Office
Lab Director RODNEY JARAMILLO

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This page was last updated on: 6/4/2025