46D2063583 CLIA NUMBER - ST MARK'S HOSPITAL-SENIOR HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 46D2063583
  • Facility Name: ST MARK'S HOSPITAL-SENIOR HEALTH CENTER
  • Facility Address: 1275 E FORT UNION BLVD, STE 150
    COTTONWOOD, UT
    ZIP 84047
  • Facility Phone: 801 268-7766
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MINA GOHARI
  • NPI Number: 1922342732
  • Taxonomy: 261QP3300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 46D2063583
LAB Type Physician Office
Facility Name ST MARK'S HOSPITAL-SENIOR HEALTH CENTER
Street 1275 E FORT UNION BLVD, STE 150
City COTTONWOOD
State UT
ZIP 84047
Phone 801 268-7766
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2025
Certificate Expiration Date 8/5/2027
Facility Type Physician Office
Lab Director MINA GOHARI

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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