46D2295023 CLIA NUMBER - GRATEFUL DIRECT PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 46D2295023
  • Facility Name: GRATEFUL DIRECT PRIMARY CARE
  • Facility Address: 8541 S REDWOOD RD, SUITE B1
    WEST JORDAN, UT
    ZIP 84088
  • Facility Phone: 801 706-0171
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GABRIELA L. WALSMAN LEIVA
  • NPI Number: 1164221974
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 46D2295023
LAB Type Physician Office
Facility Name GRATEFUL DIRECT PRIMARY CARE
Street 8541 S REDWOOD RD, SUITE B1
City WEST JORDAN
State UT
ZIP 84088
Phone 801 706-0171
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/5/2023
Certificate Expiration Date 12/4/2025
Facility Type Physician Office
Lab Director GABRIELA L. WALSMAN LEIVA

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