50D2111314 CLIA NUMBER - AESTHETICA CLINIQUE LLC

Laboratory Demographics

  • CLIA Code: 50D2111314
  • Facility Name: AESTHETICA CLINIQUE LLC
  • Facility Address: 801 PACIFIC AVE
    TACOMA, WA
    ZIP 98402
  • Facility Phone: 253 627-1001
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: LOUIS POTYONDY
  • NPI Number: 1508824293
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 50D2111314
LAB Type Ambulatory Surgery Center
Facility Name AESTHETICA CLINIQUE LLC
Street 801 PACIFIC AVE
City TACOMA
State WA
ZIP 98402
Phone 253 627-1001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2016
Certificate Expiration Date 4/4/2028
Facility Type Ambulatory Surgery Center
Lab Director LOUIS POTYONDY

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