CLIA lab
CLIA 46D1101129: Village Green Pediatrics, PC
Provo, UT. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 46D1101129 belongs to Village Green Pediatrics, PC in Provo, UT.
Certificate of Waiver, effective June 22, 2025, expires June 21, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- June 22, 2025
- Certificate expiration
- June 21, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 22, 2009
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 46D1101129
- Lab name
- Village Green Pediatrics, PC
- Address
- 1675 N Freedom Blvd #9C, Provo, UT 84604
- Phone
- (801) 377-4800
- Fax
- (801) 377-4041
Annual test volume the lab reported
- Waived tests
- 650
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Village Green Pediatrics, PC in Provo?
46D1101129, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Village Green Pediatrics, PC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 46D1101129 expire?
The CMS file lists June 21, 2027 as the certificate expiration date; the certificate took effect June 22, 2025.