46D1065411 CLIA NUMBER - BRISTOL HOSPICE-UTAH, LLC

Laboratory Demographics

  • CLIA Code: 46D1065411
  • Facility Name: BRISTOL HOSPICE-UTAH, LLC
  • Facility Address: 1638 NORTH WASHINGTON BOULEVARD, SUITE 102
    OGDEN, UT
    ZIP 84404
  • Facility Phone: 801 737-2633
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: RICHARD E. ALLEN
  • NPI Number: 1164527792
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 46D1065411
LAB Type Hospice
Facility Name BRISTOL HOSPICE-UTAH, LLC
Street 1638 NORTH WASHINGTON BOULEVARD, SUITE 102
City OGDEN
State UT
ZIP 84404
Phone 801 737-2633
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Hospice
Lab Director RICHARD E. ALLEN

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