02D0911413 CLIA NUMBER - MT SANFORD TRIBAL CONSORTIUM

Laboratory Demographics

  • CLIA Code: 02D0911413
  • Facility Name: MT SANFORD TRIBAL CONSORTIUM
  • Facility Address: MILE 33 TOK CUT OFF HWY
    GAKONA, AK
    ZIP 99586
  • Facility Phone: 907 822-5399
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: MS. EVELYN R. BEETER
  • NPI Number: 1427104959
  • Taxonomy: 261QC1500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 02D0911413
LAB Type Community Clinic
Facility Name MT SANFORD TRIBAL CONSORTIUM
Street MILE 33 TOK CUT OFF HWY
City GAKONA
State AK
ZIP 99586
Phone 907 822-5399
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2023
Certificate Expiration Date 11/12/2025
Facility Type Community Clinic
Lab Director MS. EVELYN R. BEETER

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