50D2177705 CLIA NUMBER - BAXTER PLASTIC SURGERY

Laboratory Demographics

  • CLIA Code: 50D2177705
  • Facility Name: BAXTER PLASTIC SURGERY
  • Facility Address: 6100 219TH ST SW STE 290
    MOUNTLAKE TERRACE, WA
    ZIP 98043
  • Facility Phone: 425 776-0880
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RICHARD A. BAXTER
  • NPI Number: 1174076210
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 50D2177705
LAB Type Ambulatory Surgery Center
Facility Name BAXTER PLASTIC SURGERY
Street 6100 219TH ST SW STE 290
City MOUNTLAKE TERRACE
State WA
ZIP 98043
Phone 425 776-0880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2020
Certificate Expiration Date 4/4/2028
Facility Type Ambulatory Surgery Center
Lab Director RICHARD A. BAXTER

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