46D2303706 CLIA NUMBER - PURE DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 46D2303706
  • Facility Name: PURE DERMATOLOGY
  • Facility Address: 466 E 500 S
    SALT LAKE CITY, UT
    ZIP 84111
  • Facility Phone: 801 870-5463
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: LEA D. HEDSTROM
  • NPI Number: 1902668171
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 46D2303706
LAB Type Practitioner Other
Facility Name PURE DERMATOLOGY
Street 466 E 500 S
City SALT LAKE CITY
State UT
ZIP 84111
Phone 801 870-5463
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2024
Certificate Expiration Date 4/29/2026
Facility Type Practitioner Other
Lab Director LEA D. HEDSTROM

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