46D1094237 CLIA NUMBER - SOUTH JORDAN VA CBOC

Laboratory Demographics

  • CLIA Code: 46D1094237
  • Facility Name: SOUTH JORDAN VA CBOC
  • Facility Address: 5119 W DAYBREAK PKWY
    SOUTH JORDAN, UT
    ZIP 84009
  • Facility Phone: 801 582-1565
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Accreditation
  • Lab Director: KANE WALSH
  • NPI Number: 1316442841
  • Taxonomy: 1223S0112X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 46D1094237
LAB Type Ambulatory Surgery Center
Facility Name SOUTH JORDAN VA CBOC
Street 5119 W DAYBREAK PKWY
City SOUTH JORDAN
State UT
ZIP 84009
Phone 801 582-1565
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 1/14/2009
Certificate Expiration Date 5/22/2026
Facility Type Ambulatory Surgery Center
Lab Director KANE WALSH

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