46D2188473 CLIA NUMBER - SECOND NATURE WILDERNESS PROGRAM

Laboratory Demographics

CLIA Code: 46D2188473
Facility Name: SECOND NATURE WILDERNESS PROGRAM
Facility Address: 382 W MAIN ST
DUCHESNE, UT
ZIP 84021
Facility Phone: 435 738-2040
Facility Type: Other - WILDERNESS PROGRAM
Facility Type: Waiver
Lab Director: ADAM BALLS
NPI Number: 1619191095
Taxonomy: 322D00000X - Residential Treatment Facility, Emotionally Disturbed Children

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CLIA Record

Field Name	Field Value
CLIA Number	46D2188473
LAB Type	Other - WILDERNESS PROGRAM
Facility Name	SECOND NATURE WILDERNESS PROGRAM
Street	382 W MAIN ST
City	DUCHESNE
State	UT
ZIP	84021
Phone	435 738-2040
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	7/17/2024
Certificate Expiration Date	7/16/2026
Facility Type	Other - WILDERNESS PROGRAM
Lab Director	ADAM BALLS

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