46D2112049 CLIA NUMBER - REVERE HEALTH PAYSON FAMILY

Laboratory Demographics

  • CLIA Code: 46D2112049
  • Facility Name: REVERE HEALTH PAYSON FAMILY
  • Facility Address: 97 PROFESSIONAL WAY, SUITE 2
    PAYSON, UT
    ZIP 84651
  • Facility Phone: 385 265-6040
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANA MUNN
  • NPI Number: 1508896838
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 46D2112049
LAB Type Physician Office
Facility Name REVERE HEALTH PAYSON FAMILY
Street 97 PROFESSIONAL WAY, SUITE 2
City PAYSON
State UT
ZIP 84651
Phone 385 265-6040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2024
Certificate Expiration Date 4/20/2026
Facility Type Physician Office
Lab Director DANA MUNN

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