ATHENIX BODY SCULPTING INSTITUTE
NPI 1255722336
Clinic/Center - Ambulatory Surgical in Fresno, CA
- Organization
- Clinic/Center
- Ambulatory Surgical
- CLIA Number: 05D2019729
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 05-26-2027
About ATHENIX BODY SCULPTING INSTITUTE
This page provides the complete NPI Profile along with additional information for Athenix Body Sculpting Institute, a provider established in Fresno, California operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1255722336 assigned on February 2015. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 11 years ago. The provider's is doing business as Athenix Body Sculpting Institute. The authorized official of this NPI record is Mr. James Haefner (Administration)
- NPI
- 1255722336 Verify this NPI
- Provider Legal Name
- NORTHWEST SURGICAL DEVELOPMENT OF FRESNO LLC
- Other Organization Name
- ATHENIX BODY SCULPTING INSTITUTE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 7015 N MAPLE AVE STE 102 FRESNO, CA 93720
- Location Phone
- (559) 325-7855
- Mailing Address
- 65 ENTERPRISE STE 125 ALISO VIEJO, CA 92656
- Mailing Phone
- (949) 600-9931
- Mailing Fax
- (949) 600-8029
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-11-2015
- Last Update Date
- 02-11-2015
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Ambulatory Surgical
- Taxonomy Code
- 261QA1903X
- Type
- Ambulatory Health Care Facilities
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D2019729
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- May 27, 2025
- Certificate Expiration Date
- May 26, 2027
- Laboratory Director
- GAVIN M. DRY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Athenix Body Sculpting Institute to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255722336, enumerated as an "organization" on February 11, 2015.
The provider is located at 7015 N MAPLE AVE STE 102 FRESNO, CA 93720 and the phone number is (559) 325-7855.
Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.
