46D2154458 CLIA NUMBER - CENTRAL UTAH CLINIC PC DBA FILLMORE FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 46D2154458
  • Facility Name: CENTRAL UTAH CLINIC PC DBA FILLMORE FAMILY MEDICINE
  • Facility Address: 770 SOUTH HIGHWAY 99
    FILLMORE, UT
    ZIP 84631
  • Facility Phone: 435 253-8000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CRAIG GROSE MD
  • NPI Number: 1629421524
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 46D2154458
LAB Type Physician Office
Facility Name CENTRAL UTAH CLINIC PC DBA FILLMORE FAMILY MEDICINE
Street 770 SOUTH HIGHWAY 99
City FILLMORE
State UT
ZIP 84631
Phone 435 253-8000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2024
Certificate Expiration Date 9/12/2026
Facility Type Physician Office
Lab Director CRAIG GROSE MD

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