46D2123206 CLIA NUMBER - DANIEL J HANSEN, DO, PLLC DBA NORTHERN UTAH DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 46D2123206
  • Facility Name: DANIEL J HANSEN, DO, PLLC DBA NORTHERN UTAH DERMATOLOGY
  • Facility Address: 736 S 200 W, STE #1
    SYRACUSE, UT
    ZIP 84075
  • Facility Phone: 801 399-3325
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DANIEL J. HANSEN
  • NPI Number: 1073640322
  • Taxonomy: 101YM0800X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 46D2123206
LAB Type Physician Office
Facility Name DANIEL J HANSEN, DO, PLLC DBA NORTHERN UTAH DERMATOLOGY
Street 736 S 200 W, STE #1
City SYRACUSE
State UT
ZIP 84075
Phone 801 399-3325
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/14/2024
Certificate Expiration Date 12/13/2026
Facility Type Physician Office
Lab Director DANIEL J. HANSEN

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