46D2195509 CLIA NUMBER - LOTUS PARK SENIOR LIVING

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Laboratory Demographics

CLIA Number: 46D2195509

Facility Name: LOTUS PARK SENIOR LIVING

Facility Address:
2639 W 3520 S
WEST HAVEN, UT
ZIP 84401
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Facility Phone Number: 801 732-5290

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1689926313

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	46D2195509
LAB Type	Assisted Living Facility
Facility Name	LOTUS PARK SENIOR LIVING
Street	2639 W 3520 S
City	WEST HAVEN
State	UT
ZIP	84401
Phone	801 732-5290
CertificateType	4
CertificateEffectiveDate	10/9/2022
CertificateExpirationDate	10/8/2024
FacilityType	Waiver

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