46D2308670 CLIA NUMBER - SUNDARA MEDICAL

Laboratory Demographics

  • CLIA Code: 46D2308670
  • Facility Name: SUNDARA MEDICAL
  • Facility Address: 14629 PORTER ROCKWELL BOULEVARD
    BLUFFDALE, UT
    ZIP 84065
  • Facility Phone: (801) 410-1100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TAMARA BROADHEAD
  • NPI Number: 1720825573
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 46D2308670
LAB Type Physician Office
Facility Name SUNDARA MEDICAL
Street 14629 PORTER ROCKWELL BOULEVARD
City BLUFFDALE
State UT
ZIP 84065
Phone 8014101100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2024
Certificate Expiration Date 7/30/2026
Facility Type Physician Office
Lab Director TAMARA BROADHEAD

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