46D2212842 CLIA NUMBER - ROSE CREEK PEDIATRICS, LLC

Laboratory Demographics

  • CLIA Code: 46D2212842
  • Facility Name: ROSE CREEK PEDIATRICS, LLC
  • Facility Address: 4121 W 13400 S, UNIT B
    RIVERTON, UT
    ZIP 84096
  • Facility Phone: 801 446-0102
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WOODROW C. MARRIOTT
  • NPI Number: 1750985420
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 46D2212842
LAB Type Physician Office
Facility Name ROSE CREEK PEDIATRICS, LLC
Street 4121 W 13400 S, UNIT B
City RIVERTON
State UT
ZIP 84096
Phone 801 446-0102
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2025
Certificate Expiration Date 2/7/2027
Facility Type Physician Office
Lab Director WOODROW C. MARRIOTT

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