46D1103854 CLIA NUMBER - ATHENA WOMEN'S CLINIC

Laboratory Demographics

  • CLIA Code: 46D1103854
  • Facility Name: ATHENA WOMEN'S CLINIC
  • Facility Address: 1407 NORTH STATE ST STE A
    OREM, UT
    ZIP 84057
  • Facility Phone: (801) 400-3163
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: CHRISTINE K. RENFRO
  • NPI Number: 1538391917
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 46D1103854
LAB Type Practitioner Other
Facility Name ATHENA WOMEN'S CLINIC
Street 1407 NORTH STATE ST STE A
City OREM
State UT
ZIP 84057
Phone 8014003163
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/19/2025
Certificate Expiration Date 8/18/2027
Facility Type Practitioner Other
Lab Director CHRISTINE K. RENFRO

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This page was last updated on: 5/18/2026