35D2011142 CLIA NUMBER - INSTITUTE OF FACIAL SURGERY

Laboratory Demographics

  • CLIA Code: 35D2011142
  • Facility Name: INSTITUTE OF FACIAL SURGERY
  • Facility Address: NORTHERN FACIAL SURGEONS PC 2331 TYLER PARKWAY STE #4
    BISMARCK, ND
    ZIP 58503
  • Facility Phone: 701 255-4000
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JOHN G. STANLEY
  • NPI Number: 1588697015
  • Taxonomy: 1223S0112X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 35D2011142
LAB Type Ambulatory Surgery Center
Facility Name INSTITUTE OF FACIAL SURGERY
Street NORTHERN FACIAL SURGEONS PC 2331 TYLER PARKWAY STE #4
City BISMARCK
State ND
ZIP 58503
Phone 701 255-4000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type Ambulatory Surgery Center
Lab Director JOHN G. STANLEY

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