46D1100877 CLIA NUMBER - INTERMOUNTAIN BUDGE CLINIC DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 46D1100877
  • Facility Name: INTERMOUNTAIN BUDGE CLINIC DERMATOLOGY
  • Facility Address: 1350 NORTH 500 EAST
    LOGAN, UT
    ZIP 84341
  • Facility Phone: 435 716-1770
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: NATHAN W. HANSON
  • NPI Number: 1144736372
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 46D1100877
LAB Type Physician Office
Facility Name INTERMOUNTAIN BUDGE CLINIC DERMATOLOGY
Street 1350 NORTH 500 EAST
City LOGAN
State UT
ZIP 84341
Phone 435 716-1770
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 11/12/2023
Certificate Expiration Date 11/11/2025
Facility Type Physician Office
Lab Director NATHAN W. HANSON

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