46D2234804 CLIA NUMBER - MOONRIDGE ACADEMY RTC

Laboratory Demographics

  • CLIA Code: 46D2234804
  • Facility Name: MOONRIDGE ACADEMY RTC
  • Facility Address: 9450 W 2400 S
    CEDAR CITY, UT
    ZIP 84720
  • Facility Phone: 435 704-7191
  • Facility Type: Other - RESIDENTIAL TREATMENT CEN
  • Facility Type: Waiver
  • Lab Director: JACK HINMAN
  • NPI Number: 1407988017
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 46D2234804
LAB Type Other - RESIDENTIAL TREATMENT CEN
Facility Name MOONRIDGE ACADEMY RTC
Street 9450 W 2400 S
City CEDAR CITY
State UT
ZIP 84720
Phone 435 704-7191
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/2/2025
Certificate Expiration Date 9/1/2027
Facility Type Other - RESIDENTIAL TREATMENT CEN
Lab Director JACK HINMAN

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