06D2289602 CLIA NUMBER - RESPLENDENT AESTHETICS MED SPA AND IV CENTER

Laboratory Demographics

CLIA Number: 06D2289602

Facility Name: RESPLENDENT AESTHETICS MED SPA AND IV CENTER

Facility Address:
4550 S RESERVOIR RD, SUITE D
CENTENNIAL, CO
ZIP 80015
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Facility Phone Number: 720 927-7530

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1720867831

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	06D2289602
LAB Type	Practitioner Other
Facility Name	RESPLENDENT AESTHETICS MED SPA AND IV CENTER
Street	4550 S RESERVOIR RD, SUITE D
City	CENTENNIAL
State	CO
ZIP	80015
Phone	720 927-7530
CertificateType	4
CertificateEffectiveDate	9/13/2023
CertificateExpirationDate	9/12/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024