02D0640552 CLIA NUMBER - INDEPENDENCE PARK MEDICAL SERVICES INC

Laboratory Demographics

CLIA Number: 02D0640552

Facility Name: INDEPENDENCE PARK MEDICAL SERVICES INC

Facility Address:
9500 INDEPENDENCE DRIVE, STE 400
ANCHORAGE, AK
ZIP 99507
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Facility Phone Number: 907 365-5246

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1760037550

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	02D0640552
LAB Type	Physician Office
Facility Name	INDEPENDENCE PARK MEDICAL SERVICES INC
Street	9500 INDEPENDENCE DRIVE, STE 400
City	ANCHORAGE
State	AK
ZIP	99507
Phone	907 365-5246
CertificateType	2
CertificateEffectiveDate	2/26/2023
CertificateExpirationDate	2/25/2025
FacilityType	Compliance

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