46D2018065 CLIA NUMBER - SOUTHGATE SENIOR LIVING

Laboratory Demographics

  • CLIA Code: 46D2018065
  • Facility Name: SOUTHGATE SENIOR LIVING
  • Facility Address: 134 WEST 2025 SOUTH CIRCLE
    ST GEORGE, UT
    ZIP 84770
  • Facility Phone: 435 628-1117
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: KYLIE PORTER
  • NPI Number: 1265840391
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 46D2018065
LAB Type Assisted Living Facility
Facility Name SOUTHGATE SENIOR LIVING
Street 134 WEST 2025 SOUTH CIRCLE
City ST GEORGE
State UT
ZIP 84770
Phone 435 628-1117
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/22/2024
Certificate Expiration Date 12/21/2026
Facility Type Assisted Living Facility
Lab Director KYLIE PORTER

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