46D2186911 CLIA NUMBER - MOSAIC HOUSE

Laboratory Demographics

CLIA Number: 46D2186911

Facility Name: MOSAIC HOUSE

Facility Address:
1488 E VINE ST
MURRAY, UT
ZIP 84121
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Facility Phone Number: 801 268-9300

Facility Type: Other - RESIDENTIAL SUPPORT

Certificate Type: Waiver

NPI Number: 1942667597

Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

CLIA Record

Field Name	Field Value
CLIA Number	46D2186911
LAB Type	Other - RESIDENTIAL SUPPORT
Facility Name	MOSAIC HOUSE
Street	1488 E VINE ST
City	MURRAY
State	UT
ZIP	84121
Phone	801 268-9300
CertificateType	4
CertificateEffectiveDate	6/23/2022
CertificateExpirationDate	6/22/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024