46D2043483 CLIA NUMBER - UTAH TRAUMA AND ADDICTION CENTERS

Laboratory Demographics

  • CLIA Code: 46D2043483
  • Facility Name: UTAH TRAUMA AND ADDICTION CENTERS
  • Facility Address: 2590 E PRAIRIE VEIW DRIVE
    EAGLE MOUNTAIN, UT
    ZIP 84005
  • Facility Phone: 801 766-2233
  • Facility Type: Other - RESIDENTIAL TREATMENT
  • Facility Type: Waiver
  • Lab Director: JEREMY Q. BOBERG
  • NPI Number: 1609130418
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 46D2043483
LAB Type Other - RESIDENTIAL TREATMENT
Facility Name UTAH TRAUMA AND ADDICTION CENTERS
Street 2590 E PRAIRIE VEIW DRIVE
City EAGLE MOUNTAIN
State UT
ZIP 84005
Phone 801 766-2233
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/3/2024
Certificate Expiration Date 7/2/2026
Facility Type Other - RESIDENTIAL TREATMENT
Lab Director JEREMY Q. BOBERG

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