46D2015635 CLIA NUMBER - ALTA PAIN PHYSICIANS

Laboratory Demographics

  • CLIA Code: 46D2015635
  • Facility Name: ALTA PAIN PHYSICIANS
  • Facility Address: 11333 S 1000 E #102
    SANDY, UT
    ZIP 84094
  • Facility Phone: 801 262-2205
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL M. CHEN
  • NPI Number: 1063721850
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 46D2015635
LAB Type Physician Office
Facility Name ALTA PAIN PHYSICIANS
Street 11333 S 1000 E #102
City SANDY
State UT
ZIP 84094
Phone 801 262-2205
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2024
Certificate Expiration Date 10/28/2026
Facility Type Physician Office
Lab Director MICHAEL M. CHEN

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