02D0641241 CLIA NUMBER - TANANA CHIEFS CONFERENCE INC COMMUNITY HEALTH AIDE PROGRAM

Laboratory Demographics

CLIA Code: 02D0641241
Facility Name: TANANA CHIEFS CONFERENCE INC COMMUNITY HEALTH AIDE PROGRAM
Facility Address: 201 1ST AVE STE 200
FAIRBANKS, AK
ZIP 99701
Facility Phone: 907 451-6682
Facility Type: Other
Facility Type: Waiver
Lab Director: CRYSTAL L. STORDAHL
NPI Number: 1649385667
Taxonomy: 332800000X - Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

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CLIA Record

Field Name	Field Value
CLIA Number	02D0641241
LAB Type	Other
Facility Name	TANANA CHIEFS CONFERENCE INC COMMUNITY HEALTH AIDE PROGRAM
Street	201 1ST AVE STE 200
City	FAIRBANKS
State	AK
ZIP	99701
Phone	907 451-6682
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	10/24/2023
Certificate Expiration Date	10/23/2025
Facility Type	Other
Lab Director	CRYSTAL L. STORDAHL

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