46D2288158 CLIA NUMBER - TOOELE CLINIC CORP

Laboratory Demographics

  • CLIA Code: 46D2288158
  • Facility Name: TOOELE CLINIC CORP
  • Facility Address: 196 E 2000 N, SUITE 104
    TOOELE, UT
    ZIP 84074
  • Facility Phone: (435) 843-3859
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: INGRID ACOSTA
  • NPI Number: 1073512364
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 46D2288158
LAB Type Physician Office
Facility Name TOOELE CLINIC CORP
Street 196 E 2000 N, SUITE 104
City TOOELE
State UT
ZIP 84074
Phone 4358433859
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/22/2025
Certificate Expiration Date 8/21/2027
Facility Type Physician Office
Lab Director INGRID ACOSTA

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This page was last updated on: 6/29/2026