46D2197363 CLIA NUMBER - MEDALLION SUPPORTED LIVING LEHI

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Field Name	Field Value
CLIA Number	46D2197363
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	MEDALLION SUPPORTED LIVING LEHI
Street	651 E 200 S
City	LEHI
State	UT
ZIP	84043
Phone	801 375-2710
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	10/23/2024
Certificate Expiration Date	10/22/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	KIRT KOHLER

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