46D2087969 CLIA NUMBER - UTAH VALLEY PEDIATRICS - SPANISH FORK

Laboratory Demographics

  • CLIA Code: 46D2087969
  • Facility Name: UTAH VALLEY PEDIATRICS - SPANISH FORK
  • Facility Address: 701 E 700 N
    SPANISH FORK, UT
    ZIP 84660
  • Facility Phone: 801 794-7947
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JONATHAN P. PETERSON
  • NPI Number: 1699148197
  • Taxonomy: 2081P2900X - Physical Medicine & Rehabilitation

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CLIA Record

Field Name Field Value
CLIA Number 46D2087969
LAB Type Physician Office
Facility Name UTAH VALLEY PEDIATRICS - SPANISH FORK
Street 701 E 700 N
City SPANISH FORK
State UT
ZIP 84660
Phone 801 794-7947
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2024
Certificate Expiration Date 12/8/2026
Facility Type Physician Office
Lab Director JONATHAN P. PETERSON

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