46D2186911 CLIA NUMBER - MOSAIC HOUSE

Laboratory Demographics

CLIA Code: 46D2186911
Facility Name: MOSAIC HOUSE
Facility Address: 1488 E VINE ST
MURRAY, UT
ZIP 84121
Facility Phone: 801 268-9300
Facility Type: Other - RESIDENTIAL SUPPORT
Facility Type: Waiver
Lab Director: ROBERTA OKELLEY
NPI Number: 1942667597
Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness

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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
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	6/23/2024
Certificate Expiration Date	6/22/2026
Facility Type	Other - RESIDENTIAL SUPPORT
Lab Director	ROBERTA OKELLEY

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