46D2034421 CLIA NUMBER - ST MARK'S HOSPITAL OUTPATIENT RADIATION THERAPY

Laboratory Demographics

  • CLIA Code: 46D2034421
  • Facility Name: ST MARK'S HOSPITAL OUTPATIENT RADIATION THERAPY
  • Facility Address: 1250 EAST 3900 SOUTH STE B-10
    SALT LAKE CITY, UT
    ZIP 84124
  • Facility Phone: 801 456-8401
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: TOMAS B. SKIDMORE
  • NPI Number: 1942296223
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 46D2034421
LAB Type Physician Office
Facility Name ST MARK'S HOSPITAL OUTPATIENT RADIATION THERAPY
Street 1250 EAST 3900 SOUTH STE B-10
City SALT LAKE CITY
State UT
ZIP 84124
Phone 801 456-8401
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 5/16/2024
Certificate Expiration Date 5/15/2026
Facility Type Physician Office
Lab Director TOMAS B. SKIDMORE

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This page was last updated on: 3/20/2025