46D2325230 CLIA NUMBER - DESERAE J GOBLE MD PC

Laboratory Demographics

  • CLIA Code: 46D2325230
  • Facility Name: DESERAE J GOBLE MD PC
  • Facility Address: 1451 N 200 E STE #250
    LOGAN, UT
    ZIP 84341
  • Facility Phone: 435 363-7853
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DESERAE J. GOBLE
  • NPI Number: 1366415770
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 46D2325230
LAB Type Physician Office
Facility Name DESERAE J GOBLE MD PC
Street 1451 N 200 E STE #250
City LOGAN
State UT
ZIP 84341
Phone 435 363-7853
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2025
Certificate Expiration Date 6/9/2027
Facility Type Physician Office
Lab Director DR. DESERAE J. GOBLE

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