46D2138985 CLIA NUMBER - INTERVENTIONAL MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 46D2138985
  • Facility Name: INTERVENTIONAL MEDICAL CENTER
  • Facility Address: 1972 WEST 5400 SOUTH
    TAYLORSVILLE, UT
    ZIP 84129
  • Facility Phone: 801 679-3488
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID A. PEARSON
  • NPI Number: 1558871590
  • Taxonomy: 175T00000X - Peer Specialist

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CLIA Record

Field Name Field Value
CLIA Number 46D2138985
LAB Type Physician Office
Facility Name INTERVENTIONAL MEDICAL CENTER
Street 1972 WEST 5400 SOUTH
City TAYLORSVILLE
State UT
ZIP 84129
Phone 801 679-3488
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Physician Office
Lab Director DAVID A. PEARSON

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