46D2017040 CLIA NUMBER - ODYSSEY HOUSE - MARTINDALE CLINIC

Laboratory Demographics

  • CLIA Code: 46D2017040
  • Facility Name: ODYSSEY HOUSE - MARTINDALE CLINIC
  • Facility Address: 743 EAST 300 SOUTH
    SALT LAKE CITY, UT
    ZIP 84102
  • Facility Phone: 801 634-1111
  • Facility Type: Other - SUBSTANCE ABUSE TREATMENT
  • Facility Type: Waiver
  • Lab Director: DEAN MAYER
  • NPI Number: 1407481245
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 46D2017040
LAB Type Other - SUBSTANCE ABUSE TREATMENT
Facility Name ODYSSEY HOUSE - MARTINDALE CLINIC
Street 743 EAST 300 SOUTH
City SALT LAKE CITY
State UT
ZIP 84102
Phone 801 634-1111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2024
Certificate Expiration Date 12/1/2026
Facility Type Other - SUBSTANCE ABUSE TREATMENT
Lab Director DEAN MAYER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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