46D2081605 CLIA NUMBER - MT OGDEN EYE CENTER, LLC - BOUNTIFUL

Laboratory Demographics

  • CLIA Code: 46D2081605
  • Facility Name: MT OGDEN EYE CENTER, LLC - BOUNTIFUL
  • Facility Address: 214 WEST 1500 SOUTH, SUITE 300
    BOUNTIFUL, UT
    ZIP 84010
  • Facility Phone: 801 476-0494
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BROCK HANSEN
  • NPI Number: 1740431428
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 46D2081605
LAB Type Physician Office
Facility Name MT OGDEN EYE CENTER, LLC - BOUNTIFUL
Street 214 WEST 1500 SOUTH, SUITE 300
City BOUNTIFUL
State UT
ZIP 84010
Phone 801 476-0494
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2024
Certificate Expiration Date 7/27/2026
Facility Type Physician Office
Lab Director BROCK HANSEN

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