46D2019297 CLIA NUMBER - RIDLEY'S PHARMACY #1151

Laboratory Demographics

  • CLIA Code: 46D2019297
  • Facility Name: RIDLEY'S PHARMACY #1151
  • Facility Address: 74 SOUTH 100 EAST
    TREMONTON, UT
    ZIP 84337
  • Facility Phone: 801 358-3365
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TODD R. WISE
  • NPI Number: 1508339672
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2019297
LAB Type Pharmacy
Facility Name RIDLEY'S PHARMACY #1151
Street 74 SOUTH 100 EAST
City TREMONTON
State UT
ZIP 84337
Phone 801 358-3365
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2025
Certificate Expiration Date 1/25/2027
Facility Type Pharmacy
Lab Director TODD R. WISE

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