46D2308721 CLIA NUMBER - RIVERSTONE MEDICAL

Laboratory Demographics

  • CLIA Code: 46D2308721
  • Facility Name: RIVERSTONE MEDICAL
  • Facility Address: 688 E VINE STREET, SUITE 16
    MURRAY, UT
    ZIP 84107
  • Facility Phone: 801 509-9138
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KHALID A. HARARAH
  • NPI Number: 1902675556
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 46D2308721
LAB Type Physician Office
Facility Name RIVERSTONE MEDICAL
Street 688 E VINE STREET, SUITE 16
City MURRAY
State UT
ZIP 84107
Phone 801 509-9138
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2024
Certificate Expiration Date 7/31/2026
Facility Type Physician Office
Lab Director KHALID A. HARARAH

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