02D0640489 CLIA NUMBER - PLANNED PARENTHOOD OF THE GREAT NW HAWAII, ALASKA, INDIANA, KENTUCKY

Laboratory Demographics

CLIA Number: 02D0640489

Facility Name: PLANNED PARENTHOOD OF THE GREAT NW HAWAII, ALASKA, INDIANA, KENTUCKY

Facility Address:
4001 LAKE OTIS PARKWAY, STE 101
ANCHORAGE, AK
ZIP 99508
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Facility Phone Number: 206 290-8012

Facility Type: Practitioner Other

Certificate Type: Certificate of Compliance

NPI Number: 1962804518

Taxonomy: 363LW0102X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	02D0640489
LAB Type	Practitioner Other
Facility Name	PLANNED PARENTHOOD OF THE GREAT NW HAWAII, ALASKA, INDIANA, KENTUCKY
Street	4001 LAKE OTIS PARKWAY, STE 101
City	ANCHORAGE
State	AK
ZIP	99508
Phone	206 290-8012
CertificateType	2
CertificateEffectiveDate	2/13/2023
CertificateExpirationDate	2/12/2025
FacilityType	Compliance

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