50D2013900 CLIA NUMBER - AESTHETIC FACIAL PLASTIC SURGERY

Laboratory Demographics

  • CLIA Code: 50D2013900
  • Facility Name: AESTHETIC FACIAL PLASTIC SURGERY
  • Facility Address: 1810 116TH AVE NE STE 102
    BELLEVUE, WA
    ZIP 98004
  • Facility Phone: 425 990-3223
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PHILIP A. YOUNG
  • NPI Number: 1194933291
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 50D2013900
LAB Type Ambulatory Surgery Center
Facility Name AESTHETIC FACIAL PLASTIC SURGERY
Street 1810 116TH AVE NE STE 102
City BELLEVUE
State WA
ZIP 98004
Phone 425 990-3223
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2010
Certificate Expiration Date 4/4/2028
Facility Type Ambulatory Surgery Center
Lab Director PHILIP A. YOUNG

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