46D2197791 CLIA NUMBER - HEARTHSTONE MANOR CIC ASSISTED LIVING LLC

Laboratory Demographics

  • CLIA Code: 46D2197791
  • Facility Name: HEARTHSTONE MANOR CIC ASSISTED LIVING LLC
  • Facility Address: 1424 S 1700 E
    SPANISH FORK, UT
    ZIP 84660
  • Facility Phone: 801 836-9555
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MR. CRAIG HERMANSEN
  • NPI Number: 1669924692
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 46D2197791
LAB Type Assisted Living Facility
Facility Name HEARTHSTONE MANOR CIC ASSISTED LIVING LLC
Street 1424 S 1700 E
City SPANISH FORK
State UT
ZIP 84660
Phone 801 836-9555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2024
Certificate Expiration Date 10/26/2026
Facility Type Assisted Living Facility
Lab Director MR. CRAIG HERMANSEN

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