46D2148914 CLIA NUMBER - RED WILLOW COUNSELING AND RECOVERY

Laboratory Demographics

  • CLIA Code: 46D2148914
  • Facility Name: RED WILLOW COUNSELING AND RECOVERY
  • Facility Address: 1425 SOUTH 700 EAST, SUITE#102
    SALT LAKE CITY, UT
    ZIP 84105
  • Facility Phone: 801 313-0055
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: JAMES K. OTT
  • NPI Number: 1477189900
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 46D2148914
LAB Type Comp. Outpatient Rehab Facility
Facility Name RED WILLOW COUNSELING AND RECOVERY
Street 1425 SOUTH 700 EAST, SUITE#102
City SALT LAKE CITY
State UT
ZIP 84105
Phone 801 313-0055
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2024
Certificate Expiration Date 5/21/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director JAMES K. OTT

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