46D2161023 CLIA NUMBER - LIVE FOR LIFE

Laboratory Demographics

  • CLIA Code: 46D2161023
  • Facility Name: LIVE FOR LIFE
  • Facility Address: 9045 S 1300 E, SUITE 200
    SANDY, UT
    ZIP 84094
  • Facility Phone: 801 666-6834
  • Facility Type: Other - RESIDENTIAL OUTPATIENT
  • Facility Type: Waiver
  • Lab Director: TROY SHAW
  • NPI Number: 1679062301
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 46D2161023
LAB Type Other - RESIDENTIAL OUTPATIENT
Facility Name LIVE FOR LIFE
Street 9045 S 1300 E, SUITE 200
City SANDY
State UT
ZIP 84094
Phone 801 666-6834
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2025
Certificate Expiration Date 1/23/2027
Facility Type Other - RESIDENTIAL OUTPATIENT
Lab Director TROY SHAW

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