46D2176320 CLIA NUMBER - WASATCH VASCULAR CENTER ASC, LLC DBA WASATCH VASCULAR CARE

Laboratory Demographics

  • CLIA Code: 46D2176320
  • Facility Name: WASATCH VASCULAR CENTER ASC, LLC DBA WASATCH VASCULAR CARE
  • Facility Address: 3702 SOUTH STATE STREET, SUITE 103
    SALT LAKE CITY, UT
    ZIP 84115
  • Facility Phone: 801 281-0027
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES CARLISLE
  • NPI Number: 1558905398
  • Taxonomy: 2085R0204X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 46D2176320
LAB Type Physician Office
Facility Name WASATCH VASCULAR CENTER ASC, LLC DBA WASATCH VASCULAR CARE
Street 3702 SOUTH STATE STREET, SUITE 103
City SALT LAKE CITY
State UT
ZIP 84115
Phone 801 281-0027
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2023
Certificate Expiration Date 12/11/2025
Facility Type Physician Office
Lab Director JAMES CARLISLE

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