46D2290252 CLIA NUMBER - SALT LAKE RETINA

Laboratory Demographics

  • CLIA Code: 46D2290252
  • Facility Name: SALT LAKE RETINA
  • Facility Address: 3465 S 4155 W, #4
    WEST VALLEY CITY, UT
    ZIP 84120
  • Facility Phone: 801 260-0034
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANDREW DAVIS
  • NPI Number: 1508052234
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 46D2290252
LAB Type Physician Office
Facility Name SALT LAKE RETINA
Street 3465 S 4155 W, #4
City WEST VALLEY CITY
State UT
ZIP 84120
Phone 801 260-0034
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2025
Certificate Expiration Date 9/21/2027
Facility Type Physician Office
Lab Director ANDREW DAVIS

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