46D0948264 CLIA NUMBER - GATEWAY AESTHETIC INSTITUTE & LASER CENTER

Laboratory Demographics

CLIA Number: 46D0948264

Facility Name: GATEWAY AESTHETIC INSTITUTE & LASER CENTER

Facility Address:
650 MAIN ST, STE 100
SALT LAKE CITY, UT
ZIP 84101
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Facility Phone Number: 801 595-1600

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1124208343

Taxonomy: 284300000X - Special Hospital
A designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have specified medical conditions, both surgical and nonsurgical.

CLIA Record

Field Name	Field Value
CLIA Number	46D0948264
LAB Type	Physician Office
Facility Name	GATEWAY AESTHETIC INSTITUTE & LASER CENTER
Street	650 MAIN ST, STE 100
City	SALT LAKE CITY
State	UT
ZIP	84101
Phone	801 595-1600
CertificateType	3
CertificateEffectiveDate	7/26/2022
CertificateExpirationDate	7/25/2024
FacilityType	PPMP

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