50D2039119 CLIA NUMBER - ATHENIX BODY SCULPTING INSTITUTE

Laboratory Demographics

  • CLIA Code: 50D2039119
  • Facility Name: ATHENIX BODY SCULPTING INSTITUTE
  • Facility Address: 636 120TH AVE NE STE 202
    BELLEVUE, WA
    ZIP 98005
  • Facility Phone: 425 454-2410
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: GAVIN DRY
  • NPI Number: 1801203310
  • Taxonomy: 2086S0122X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 50D2039119
LAB Type Ambulatory Surgery Center
Facility Name ATHENIX BODY SCULPTING INSTITUTE
Street 636 120TH AVE NE STE 202
City BELLEVUE
State WA
ZIP 98005
Phone 425 454-2410
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2012
Certificate Expiration Date 4/4/2028
Facility Type Ambulatory Surgery Center
Lab Director GAVIN DRY

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