46D2146067 CLIA NUMBER - JOLLEYS CORNER DRUGSTORE

Laboratory Demographics

  • CLIA Code: 46D2146067
  • Facility Name: JOLLEYS CORNER DRUGSTORE
  • Facility Address: 1676 EAST 1300 SOUTH
    SALT LAKE CITY, UT
    ZIP 84105
  • Facility Phone: 801 582-1999
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TREVOR R. JOLLEY
  • NPI Number: 1588724397
  • Taxonomy: 183700000X - Pharmacy Technician

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CLIA Record

Field Name Field Value
CLIA Number 46D2146067
LAB Type Pharmacy
Facility Name JOLLEYS CORNER DRUGSTORE
Street 1676 EAST 1300 SOUTH
City SALT LAKE CITY
State UT
ZIP 84105
Phone 801 582-1999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2024
Certificate Expiration Date 3/20/2026
Facility Type Pharmacy
Lab Director TREVOR R. JOLLEY

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