46D2007718 CLIA NUMBER - ACTIVE HOME HEALTH

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Laboratory Demographics

CLIA Number: 46D2007718

Facility Name: ACTIVE HOME HEALTH

Facility Address:
8180 S 700 E, SUITE 100
SANDY, UT
ZIP 84070
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Facility Phone Number: 801 438-6285

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1528428190

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	46D2007718
LAB Type	Home Health Agency
Facility Name	ACTIVE HOME HEALTH
Street	8180 S 700 E, SUITE 100
City	SANDY
State	UT
ZIP	84070
Phone	801 438-6285
CertificateType	4
CertificateEffectiveDate	5/24/2022
CertificateExpirationDate	5/23/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024