46D2171730 CLIA NUMBER - PROFESSIONAL PLAZA PHARMACY

Laboratory Demographics

  • CLIA Code: 46D2171730
  • Facility Name: PROFESSIONAL PLAZA PHARMACY
  • Facility Address: 2065 N ROBINS DRIVE
    LAYTON, UT
    ZIP 84041
  • Facility Phone: 801 773-3863
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENNETH L. ERNSTROM
  • NPI Number: 1316958804
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2171730
LAB Type Pharmacy
Facility Name PROFESSIONAL PLAZA PHARMACY
Street 2065 N ROBINS DRIVE
City LAYTON
State UT
ZIP 84041
Phone 801 773-3863
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2025
Certificate Expiration Date 9/8/2027
Facility Type Pharmacy
Lab Director KENNETH L. ERNSTROM

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