46D2099023 CLIA NUMBER - PINE TOP MEDICAL

Laboratory Demographics

  • CLIA Code: 46D2099023
  • Facility Name: PINE TOP MEDICAL
  • Facility Address: 284 N HOSPITAL DRIVE, SUITE 2
    PRICE, UT
    ZIP 84501
  • Facility Phone: 435 637-5690
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EUGENE D. LARSEN
  • NPI Number: 1679956445
  • Taxonomy: 261Q00000X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 46D2099023
LAB Type Physician Office
Facility Name PINE TOP MEDICAL
Street 284 N HOSPITAL DRIVE, SUITE 2
City PRICE
State UT
ZIP 84501
Phone 435 637-5690
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2025
Certificate Expiration Date 7/19/2027
Facility Type Physician Office
Lab Director EUGENE D. LARSEN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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