50D2097075 CLIA NUMBER - PLASTIC AND RECONSTRUCTIVE SURGEONS ASC

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Laboratory Demographics

CLIA Number: 50D2097075

Facility Name: PLASTIC AND RECONSTRUCTIVE SURGEONS ASC

Facility Address:
17930 TALBOT RD S
RENTON, WA
ZIP 98055
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Facility Phone Number: 425 228-3187

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1316109309

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	50D2097075
LAB Type	Ambulatory Surgery Center
Facility Name	PLASTIC AND RECONSTRUCTIVE SURGEONS ASC
Street	17930 TALBOT RD S
City	RENTON
State	WA
ZIP	98055
Phone	425 228-3187
CertificateType	4
CertificateEffectiveDate	6/8/2015
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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