46D2215277 CLIA NUMBER - INTERMOUNTAIN SPANISH FORK CLINIC

Laboratory Demographics

  • CLIA Code: 46D2215277
  • Facility Name: INTERMOUNTAIN SPANISH FORK CLINIC
  • Facility Address: 819 EAST MARKETPLACE DRIVE
    SPANISH FORK, UT
    ZIP 84660
  • Facility Phone: 385 344-6600
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. BRITTON ERCANBRACK
  • NPI Number: 1265632319
  • Taxonomy: 111NR0200X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 46D2215277
LAB Type Physician Office
Facility Name INTERMOUNTAIN SPANISH FORK CLINIC
Street 819 EAST MARKETPLACE DRIVE
City SPANISH FORK
State UT
ZIP 84660
Phone 385 344-6600
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/2/2025
Certificate Expiration Date 3/1/2027
Facility Type Physician Office
Lab Director DR. BRITTON ERCANBRACK

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