46D2056118 CLIA NUMBER - NUVISTA PLASTIC SURGERY

Laboratory Demographics

  • CLIA Code: 46D2056118
  • Facility Name: NUVISTA PLASTIC SURGERY
  • Facility Address: 10 WEST SCENIC POINT DRIVE #103
    DRAPER, UT
    ZIP 84020
  • Facility Phone: (801) 261-5791
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: J DAYNE D. PETERSEN
  • NPI Number: 1346597507
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 46D2056118
LAB Type Physician Office
Facility Name NUVISTA PLASTIC SURGERY
Street 10 WEST SCENIC POINT DRIVE #103
City DRAPER
State UT
ZIP 84020
Phone 8012615791
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2025
Certificate Expiration Date 3/20/2027
Facility Type Physician Office
Lab Director J DAYNE D. PETERSEN

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This page was last updated on: 5/18/2026