02D0720693 CLIA NUMBER - FRESENIUS MEDICAL CARE FAIRBANKS

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Laboratory Demographics

CLIA Number: 02D0720693

Facility Name: FRESENIUS MEDICAL CARE FAIRBANKS

Facility Address:
1863 AIRPORT WAY
FAIRBANKS, AK
ZIP 99701
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Facility Phone Number: 907 452-2900

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1679912059

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	02D0720693
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FRESENIUS MEDICAL CARE FAIRBANKS
Street	1863 AIRPORT WAY
City	FAIRBANKS
State	AK
ZIP	99701
Phone	907 452-2900
CertificateType	4
CertificateEffectiveDate	12/16/2023
CertificateExpirationDate	12/15/2025
FacilityType	Waiver

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