46D2280197 CLIA NUMBER - UTAH CVS PHARMACY, LLC DBA CVS-PHARMACY #10308

Laboratory Demographics

  • CLIA Code: 46D2280197
  • Facility Name: UTAH CVS PHARMACY, LLC DBA CVS-PHARMACY #10308
  • Facility Address: 4968 WEST 13400 SOUTH
    HERRIMAN, UT
    ZIP 84096
  • Facility Phone: 801 254-6135
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RANDY FREEMAN
  • NPI Number: 1245651850
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2280197
LAB Type Pharmacy
Facility Name UTAH CVS PHARMACY, LLC DBA CVS-PHARMACY #10308
Street 4968 WEST 13400 SOUTH
City HERRIMAN
State UT
ZIP 84096
Phone 801 254-6135
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Pharmacy
Lab Director RANDY FREEMAN

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