46D2194391 CLIA NUMBER - TOOELE COUNTY DETENTION CENTER

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Laboratory Demographics

CLIA Number: 46D2194391

Facility Name: TOOELE COUNTY DETENTION CENTER

Facility Address:
1960 S MAIN STREET
TOOELE, UT
ZIP 84074
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Facility Phone Number: 435 277-4211

Facility Type: Other - COUNTY JAIL

Certificate Type: Waiver

NPI Number: 1225068398

Taxonomy: 305S00000X - Point of Service
This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.

CLIA Record

Field Name	Field Value
CLIA Number	46D2194391
LAB Type	Other - COUNTY JAIL
Facility Name	TOOELE COUNTY DETENTION CENTER
Street	1960 S MAIN STREET
City	TOOELE
State	UT
ZIP	84074
Phone	435 277-4211
CertificateType	4
CertificateEffectiveDate	9/30/2022
CertificateExpirationDate	9/29/2024
FacilityType	Waiver

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