38D2108695 CLIA NUMBER - ATHENIX BODY SCULPTING INSTITUTE

Laboratory Demographics

  • CLIA Code: 38D2108695
  • Facility Name: ATHENIX BODY SCULPTING INSTITUTE
  • Facility Address: 17885 NW EVERGREEN PKWY SUITE 110
    BEAVERTON, OR
    ZIP 97006
  • Facility Phone: 971 246-5291
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: GAVIN DRY
  • NPI Number: 1023530094
  • Taxonomy: 2086S0122X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 38D2108695
LAB Type Ambulatory Surgery Center
Facility Name ATHENIX BODY SCULPTING INSTITUTE
Street 17885 NW EVERGREEN PKWY SUITE 110
City BEAVERTON
State OR
ZIP 97006
Phone 971 246-5291
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2024
Certificate Expiration Date 2/8/2026
Facility Type Ambulatory Surgery Center
Lab Director GAVIN DRY

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This page was last updated on: 3/20/2025