46D2031656 CLIA NUMBER - AMERICAN EXPRESS COMPANY

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Laboratory Demographics

CLIA Number: 46D2031656

Facility Name: AMERICAN EXPRESS COMPANY

Facility Address:
115 WEST TOWNE RIDGE PARKWAY
SANDY, UT
ZIP 84070
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Facility Phone Number: 801 945-5015

Facility Type: Other - CORPORATE OCC HEALTH

Certificate Type: Waiver

NPI Number: 1265615397

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	46D2031656
LAB Type	Other - CORPORATE OCC HEALTH
Facility Name	AMERICAN EXPRESS COMPANY
Street	115 WEST TOWNE RIDGE PARKWAY
City	SANDY
State	UT
ZIP	84070
Phone	801 945-5015
CertificateType	4
CertificateEffectiveDate	10/24/2023
CertificateExpirationDate	10/23/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024