46D2098052 CLIA NUMBER - MAPLE MOUNTAIN PHARMACY

Laboratory Demographics

  • CLIA Code: 46D2098052
  • Facility Name: MAPLE MOUNTAIN PHARMACY
  • Facility Address: 724 S 1600 W
    MAPLETON, UT
    ZIP 84664
  • Facility Phone: 801 515-6048
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL T. JOHNSON
  • NPI Number: 1487192621
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2098052
LAB Type Pharmacy
Facility Name MAPLE MOUNTAIN PHARMACY
Street 724 S 1600 W
City MAPLETON
State UT
ZIP 84664
Phone 801 515-6048
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2025
Certificate Expiration Date 6/28/2027
Facility Type Pharmacy
Lab Director MICHAEL T. JOHNSON

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