46D2066142 CLIA NUMBER - CENTRAL UTAH CLINIC, PC PROVO ENT

Laboratory Demographics

  • CLIA Code: 46D2066142
  • Facility Name: CENTRAL UTAH CLINIC, PC PROVO ENT
  • Facility Address: 2230 N UNIVERSITY PARKWAY, SUITE 9-B
    PROVO, UT
    ZIP 84604
  • Facility Phone: 801 375-3175
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIPP M. ROBINS
  • NPI Number: 1265907620
  • Taxonomy: 332H00000X - Eyewear Supplier

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 46D2066142
LAB Type Physician Office
Facility Name CENTRAL UTAH CLINIC, PC PROVO ENT
Street 2230 N UNIVERSITY PARKWAY, SUITE 9-B
City PROVO
State UT
ZIP 84604
Phone 801 375-3175
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2025
Certificate Expiration Date 9/22/2027
Facility Type Physician Office
Lab Director KIPP M. ROBINS

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