02D0641001 CLIA NUMBER - NINILCHIK COMMUNITY CLINIC

Laboratory Demographics

  • CLIA Code: 02D0641001
  • Facility Name: NINILCHIK COMMUNITY CLINIC
  • Facility Address: 15765 KINGSLEY ROAD
    NINILCHIK, AK
    ZIP 99639
  • Facility Phone: 907 567-3370
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: DR. SARAH SPENCER
  • NPI Number: 1053302620
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 02D0641001
LAB Type Community Clinic
Facility Name NINILCHIK COMMUNITY CLINIC
Street 15765 KINGSLEY ROAD
City NINILCHIK
State AK
ZIP 99639
Phone 907 567-3370
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/22/2025
Certificate Expiration Date 9/21/2027
Facility Type Community Clinic
Lab Director DR. SARAH SPENCER

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