46D2276566 CLIA NUMBER - INTERMOUNTAIN ROY FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 46D2276566
  • Facility Name: INTERMOUNTAIN ROY FAMILY MEDICINE
  • Facility Address: 1915 W 5950 S, DEPT 40000-7302
    ROY, UT
    ZIP 84067
  • Facility Phone: 801 387-8100
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MIKIO OBAYASHI
  • NPI Number: 1942332465
  • Taxonomy: 282NC0060X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 46D2276566
LAB Type Physician Office
Facility Name INTERMOUNTAIN ROY FAMILY MEDICINE
Street 1915 W 5950 S, DEPT 40000-7302
City ROY
State UT
ZIP 84067
Phone 801 387-8100
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 2/10/2025
Certificate Expiration Date 2/9/2027
Facility Type Physician Office
Lab Director MIKIO OBAYASHI

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