46D2212958 CLIA NUMBER - CASCADE ACADEMY, LLC

Laboratory Demographics

CLIA Code: 46D2212958
Facility Name: CASCADE ACADEMY, LLC
Facility Address: 430 WEST 200 NORTH
MIDWAY, UT
ZIP 84049
Facility Phone: 801 655-3886
Facility Type: Independent
Facility Type: Waiver
Lab Director: GERRARD D. BRADFORD
NPI Number: 1003430133
Taxonomy: 322D00000X - Residential Treatment Facility, Emotionally Disturbed Children

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CLIA Record

Field Name	Field Value
CLIA Number	46D2212958
LAB Type	Independent
Facility Name	CASCADE ACADEMY, LLC
Street	430 WEST 200 NORTH
City	MIDWAY
State	UT
ZIP	84049
Phone	801 655-3886
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	2/9/2025
Certificate Expiration Date	2/8/2027
Facility Type	Independent
Lab Director	GERRARD D. BRADFORD

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