46D2265525 CLIA NUMBER - INTEGRATED CLINICAL RESEARCH, LLC

Laboratory Demographics

  • CLIA Code: 46D2265525
  • Facility Name: INTEGRATED CLINICAL RESEARCH, LLC
  • Facility Address: 1664 S DIXIE DR, STE F-102
    ST GEORGE, UT
    ZIP 84770
  • Facility Phone: 435 703-9647
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ALBERTO W. SOUZA
  • NPI Number: 1972141588
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 46D2265525
LAB Type Practitioner Other
Facility Name INTEGRATED CLINICAL RESEARCH, LLC
Street 1664 S DIXIE DR, STE F-102
City ST GEORGE
State UT
ZIP 84770
Phone 435 703-9647
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2024
Certificate Expiration Date 7/27/2026
Facility Type Practitioner Other
Lab Director ALBERTO W. SOUZA

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