46D2130559 CLIA NUMBER - RENAISSANCE RANCH BLUFFDALE - MENS

Laboratory Demographics

  • CLIA Code: 46D2130559
  • Facility Name: RENAISSANCE RANCH BLUFFDALE - MENS
  • Facility Address: 2973 W 13800 S
    BLUFFDALE, UT
    ZIP 84065
  • Facility Phone: 801 856-7836
  • Facility Type: Other - DRUG TESTING
  • Facility Type: Waiver
  • Lab Director: TYSON DIXON
  • NPI Number: 1780129445
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 46D2130559
LAB Type Other - DRUG TESTING
Facility Name RENAISSANCE RANCH BLUFFDALE - MENS
Street 2973 W 13800 S
City BLUFFDALE
State UT
ZIP 84065
Phone 801 856-7836
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Other - DRUG TESTING
Lab Director TYSON DIXON

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