46D2034864 CLIA NUMBER - EASTERN UTAH SPINE AND PAIN

Laboratory Demographics

  • CLIA Code: 46D2034864
  • Facility Name: EASTERN UTAH SPINE AND PAIN
  • Facility Address: 335 N FAIRGROUNDS RD, STE 1
    PRICE, UT
    ZIP 84501
  • Facility Phone: 435 613-7246
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RUSSELL O. BEECHER
  • NPI Number: 1407304454
  • Taxonomy: 208VP0000X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 46D2034864
LAB Type Physician Office
Facility Name EASTERN UTAH SPINE AND PAIN
Street 335 N FAIRGROUNDS RD, STE 1
City PRICE
State UT
ZIP 84501
Phone 435 613-7246
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2024
Certificate Expiration Date 1/4/2026
Facility Type Physician Office
Lab Director RUSSELL O. BEECHER

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