46D2274287 CLIA NUMBER - PRIMARY HEALTHCARE

Laboratory Demographics

  • CLIA Code: 46D2274287
  • Facility Name: PRIMARY HEALTHCARE
  • Facility Address: 6095 S FASHION BLVD, STE 220
    MURRAY, UT
    ZIP 84107
  • Facility Phone: 801 758-8735
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEVIN MANGUM
  • NPI Number: 1700503182
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 46D2274287
LAB Type Physician Office
Facility Name PRIMARY HEALTHCARE
Street 6095 S FASHION BLVD, STE 220
City MURRAY
State UT
ZIP 84107
Phone 801 758-8735
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2024
Certificate Expiration Date 12/29/2026
Facility Type Physician Office
Lab Director KEVIN MANGUM

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