46D2128767 CLIA NUMBER - LEE'S MARKETPLACE - FOXBORO PHARMACY

Laboratory Demographics

  • CLIA Code: 46D2128767
  • Facility Name: LEE'S MARKETPLACE - FOXBORO PHARMACY
  • Facility Address: 725 N REDWOOD RD
    N SALT LAKE, UT
    ZIP 84054
  • Facility Phone: 385 322-7900
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CRYSTAL A. GRIMES
  • NPI Number: 1083157382
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2128767
LAB Type Pharmacy
Facility Name LEE'S MARKETPLACE - FOXBORO PHARMACY
Street 725 N REDWOOD RD
City N SALT LAKE
State UT
ZIP 84054
Phone 385 322-7900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Pharmacy
Lab Director CRYSTAL A. GRIMES

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