46D2163068 CLIA NUMBER - PCO-KTA LLC DBA KENT'S PHARMACY

Laboratory Demographics

  • CLIA Code: 46D2163068
  • Facility Name: PCO-KTA LLC DBA KENT'S PHARMACY
  • Facility Address: 3673 WEST 2600 NORTH
    PLAIN CITY, UT
    ZIP 84404
  • Facility Phone: 801 827-0688
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARK W. SCHULTZ
  • NPI Number: 1134645526
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2163068
LAB Type Pharmacy
Facility Name PCO-KTA LLC DBA KENT'S PHARMACY
Street 3673 WEST 2600 NORTH
City PLAIN CITY
State UT
ZIP 84404
Phone 801 827-0688
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/6/2025
Certificate Expiration Date 3/5/2027
Facility Type Pharmacy
Lab Director MARK W. SCHULTZ

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