18D2215812 CLIA NUMBER - COMMONWEALTH PLASTIC SURGERY

Laboratory Demographics

  • CLIA Code: 18D2215812
  • Facility Name: COMMONWEALTH PLASTIC SURGERY
  • Facility Address: 715 SHAKER DR, SUITE 101
    LEXINGTON, KY
    ZIP 40504
  • Facility Phone: 859 277-9435
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JARED C. NIMTZ
  • NPI Number: 1952720880
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 18D2215812
LAB Type Physician Office
Facility Name COMMONWEALTH PLASTIC SURGERY
Street 715 SHAKER DR, SUITE 101
City LEXINGTON
State KY
ZIP 40504
Phone 859 277-9435
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2025
Certificate Expiration Date 3/7/2027
Facility Type Physician Office
Lab Director DR. JARED C. NIMTZ

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