46D2284220 CLIA NUMBER - UTAH VALLEY PEDIATRICS EAGLE MOUNTAIN RANCHES

Laboratory Demographics

  • CLIA Code: 46D2284220
  • Facility Name: UTAH VALLEY PEDIATRICS EAGLE MOUNTAIN RANCHES
  • Facility Address: 3578 E PONY EXPRSS PARKWAY, SUITE 104
    EAGLE MOUNTAIN, UT
    ZIP 84005
  • Facility Phone: 801 407-6500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSEPH HERSHKOP
  • NPI Number: 1780460253
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 46D2284220
LAB Type Physician Office
Facility Name UTAH VALLEY PEDIATRICS EAGLE MOUNTAIN RANCHES
Street 3578 E PONY EXPRSS PARKWAY, SUITE 104
City EAGLE MOUNTAIN
State UT
ZIP 84005
Phone 801 407-6500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/20/2025
Certificate Expiration Date 6/19/2027
Facility Type Physician Office
Lab Director JOSEPH HERSHKOP

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This page was last updated on: 6/4/2025