02D0953917 CLIA NUMBER - HEART OF EAGLE RIVER MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 02D0953917

Facility Name: HEART OF EAGLE RIVER MEDICAL CLINIC

Facility Address:
11432 BUSINESS BLVD, SUITE 4
EAGLE RIVER, AK
ZIP 99577
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Facility Phone Number: 907 694-1300

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1033277041

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	02D0953917
LAB Type	Physician Office
Facility Name	HEART OF EAGLE RIVER MEDICAL CLINIC
Street	11432 BUSINESS BLVD, SUITE 4
City	EAGLE RIVER
State	AK
ZIP	99577
Phone	907 694-1300
CertificateType	3
CertificateEffectiveDate	11/13/2022
CertificateExpirationDate	11/12/2024
FacilityType	PPMP

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