46D2160570 CLIA NUMBER - PETTIT PEDIATRICS, LLC

Laboratory Demographics

  • CLIA Code: 46D2160570
  • Facility Name: PETTIT PEDIATRICS, LLC
  • Facility Address: 1360 W HIGHWAY 40
    VERNAL, UT
    ZIP 84078
  • Facility Phone: 435 789-7337
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ETHAN C. PETTIT
  • NPI Number: 1518435452
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 46D2160570
LAB Type Physician Office
Facility Name PETTIT PEDIATRICS, LLC
Street 1360 W HIGHWAY 40
City VERNAL
State UT
ZIP 84078
Phone 435 789-7337
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2025
Certificate Expiration Date 1/13/2027
Facility Type Physician Office
Lab Director ETHAN C. PETTIT

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