46D2069689 CLIA NUMBER - GRANGER MEDICAL CLINIC - DRAPER

Laboratory Demographics

  • CLIA Code: 46D2069689
  • Facility Name: GRANGER MEDICAL CLINIC - DRAPER
  • Facility Address: 11724 SOUTH STATE ST
    DRAPER, UT
    ZIP 84020
  • Facility Phone: 801 576-2010
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SUSAN PRATER
  • NPI Number: 1174968051
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 46D2069689
LAB Type Physician Office
Facility Name GRANGER MEDICAL CLINIC - DRAPER
Street 11724 SOUTH STATE ST
City DRAPER
State UT
ZIP 84020
Phone 801 576-2010
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/28/2024
Certificate Expiration Date 9/27/2026
Facility Type Physician Office
Lab Director SUSAN PRATER

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