46D2069689 CLIA NUMBER - GRANGER MEDICAL CLINIC - DRAPER

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Laboratory Demographics

CLIA Number: 46D2069689

Facility Name: GRANGER MEDICAL CLINIC - DRAPER

Facility Address:
11724 SOUTH STATE STREET
DRAPER, UT
ZIP 84020
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Facility Phone Number: 801 576-2010

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1174968051

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	46D2069689
LAB Type	Physician Office
Facility Name	GRANGER MEDICAL CLINIC - DRAPER
Street	11724 SOUTH STATE STREET
City	DRAPER
State	UT
ZIP	84020
Phone	801 576-2010
CertificateType	3
CertificateEffectiveDate	9/28/2022
CertificateExpirationDate	9/27/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024