46D2083845 CLIA NUMBER - PROVO CANYON SCHOOL

Laboratory Demographics

  • CLIA Code: 46D2083845
  • Facility Name: PROVO CANYON SCHOOL
  • Facility Address: 763 NORTH 1650 WEST
    SPRINGVILLE, UT
    ZIP 84663
  • Facility Phone: 801 704-1312
  • Facility Type: Other - RESIDENTIAL PHYCHIATRIC
  • Facility Type: Waiver
  • Lab Director: DELBERT P. PEARSON MD
  • NPI Number: 1427436401
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 46D2083845
LAB Type Other - RESIDENTIAL PHYCHIATRIC
Facility Name PROVO CANYON SCHOOL
Street 763 NORTH 1650 WEST
City SPRINGVILLE
State UT
ZIP 84663
Phone 801 704-1312
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2024
Certificate Expiration Date 1/15/2026
Facility Type Other - RESIDENTIAL PHYCHIATRIC
Lab Director DELBERT P. PEARSON MD

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