50D2097075 CLIA NUMBER - PLASTIC AND RECONSTRUCTIVE SURGEONS ASC

Laboratory Demographics

  • CLIA Code: 50D2097075
  • Facility Name: PLASTIC AND RECONSTRUCTIVE SURGEONS ASC
  • Facility Address: 17930 TALBOT RD S
    RENTON, WA
    ZIP 98055
  • Facility Phone: 425 228-3187
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JONATHAN HUTTER
  • NPI Number: 1316109309
  • Taxonomy: 261QA1903X - Clinic/Center

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/8/2015
Certificate Expiration Date 4/4/2028
Facility Type Ambulatory Surgery Center
Lab Director JONATHAN HUTTER

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