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CIRQUE LODGE INC
NPI 1437692241
Substance Abuse Rehabilitation Facility in Sundance, UT

Active since November 28, 2016CLIA Certified · 2 labs
3114 E IDA'S ROAD, SUNDANCE, UT 84604(801) 222-9200(801) 222-0112 Get Directions Write a Review

NPPES record last updated: November 28, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Cirque Lodge Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CIRQUE LODGE INC (NPI 1437692241) is a healthcare organization registered as a substance abuse rehabilitation facility in Sundance, Utah and active in the NPI registry since November 2016. The organization holds 2 active CLIA laboratory certificates and lists Gary Fisher, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1437692241
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameCIRQUE LODGE INC
Location Address3114 E IDA'S ROADSundance, UT 84604
Mailing AddressRr 3 Box A10Sundance, UT 84604-8901 · (801) 222-9200 · Fax (801) 222-0112
Phone(801) 222-9200
Fax(801) 222-0112
Organization SubpartNo
Authorized OfficialGary FisherExecutive Director · (801) 222-9200
Enumeration DateNovember 28, 2016
✔ NPI 1437692241 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
License✔ Licensed in UT · 28275
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
3114 E IDA'S ROAD, Sundance, UT 84604
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CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D1082831

Cirque Lodge · Sundance, UT
Active · expires Apr 20, 2028
CLIA Number46D1082831
Laboratory TypeOther
Certificate Effective DateApril 21, 2026
Certificate Expiration DateApril 20, 2028
Laboratory DirectorGary Fisher
Laboratory Phone(801) 222-9200
Laboratory LocationCirque Lodge3114 E Idas Rd, Sundance, UT 84604
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 46D1082023

Cirque Lodge · Orem, UT
Active · expires Mar 30, 2028
CLIA Number46D1082023
Laboratory TypeOther
Certificate Effective DateMarch 31, 2026
Certificate Expiration DateMarch 30, 2028
Laboratory DirectorGary Fisher
Laboratory Phone(801) 222-9200
Laboratory LocationCirque Lodge777 N Palisade Dr, Orem, UT 84097
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cirque Lodge Inc's NPI number?

The NPI number for Cirque Lodge Inc is 1437692241. It was assigned to this organization in the NPPES registry on November 28, 2016.

Where is Cirque Lodge Inc located?

Cirque Lodge Inc is located at 3114 E Ida's Road, Sundance, UT 84604. The listed phone number is (801) 222-9200.

What is Cirque Lodge Inc's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Cirque Lodge Inc hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Cirque Lodge Inc was last updated on November 28, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.