46D2118271 CLIA NUMBER - LEGACY TREATMENT CENTER

Laboratory Demographics

  • CLIA Code: 46D2118271
  • Facility Name: LEGACY TREATMENT CENTER
  • Facility Address: 1764 W ASPEN LANE
    LOA, UT
    ZIP 84747
  • Facility Phone: 435 836-2272
  • Facility Type: Other - RESIDENTIAL TREATMENT CEN
  • Facility Type: Waiver
  • Lab Director: GILBERT HALLOWS
  • NPI Number: 1609266642
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 46D2118271
LAB Type Other - RESIDENTIAL TREATMENT CEN
Facility Name LEGACY TREATMENT CENTER
Street 1764 W ASPEN LANE
City LOA
State UT
ZIP 84747
Phone 435 836-2272
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/6/2024
Certificate Expiration Date 9/5/2026
Facility Type Other - RESIDENTIAL TREATMENT CEN
Lab Director GILBERT HALLOWS

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