46D2010206 CLIA NUMBER - MA BO PC DBA HOUSE CALL DOCTORS

Laboratory Demographics

  • CLIA Code: 46D2010206
  • Facility Name: MA BO PC DBA HOUSE CALL DOCTORS
  • Facility Address: 466 EAST 500 SOUTH, SUITE 200
    SALT LAKE CITY, UT
    ZIP 84111
  • Facility Phone: 801 485-5055
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: MARK J. CACCIAMANI
  • NPI Number: 1740461219
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 46D2010206
LAB Type Mobile Laboratory
Facility Name MA BO PC DBA HOUSE CALL DOCTORS
Street 466 EAST 500 SOUTH, SUITE 200
City SALT LAKE CITY
State UT
ZIP 84111
Phone 801 485-5055
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2024
Certificate Expiration Date 7/21/2026
Facility Type Mobile Laboratory
Lab Director MARK J. CACCIAMANI

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