46D2011519 CLIA NUMBER - FAIRFIELD VILLAGE REHABILITATION

Laboratory Demographics

  • CLIA Code: 46D2011519
  • Facility Name: FAIRFIELD VILLAGE REHABILITATION
  • Facility Address: 1203 NORTH FAIRFIELD RD
    LAYTON, UT
    ZIP 84041
  • Facility Phone: 801 807-0111
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KRISTIN PORM
  • NPI Number: 1477958353
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 46D2011519
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name FAIRFIELD VILLAGE REHABILITATION
Street 1203 NORTH FAIRFIELD RD
City LAYTON
State UT
ZIP 84041
Phone 801 807-0111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2024
Certificate Expiration Date 8/16/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director KRISTIN PORM

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