02D0993341 CLIA NUMBER - WASILLA INTERNAL MEDICINE LLC

Laboratory Demographics

  • CLIA Code: 02D0993341
  • Facility Name: WASILLA INTERNAL MEDICINE LLC
  • Facility Address: 3719 MERIDIAN LOOP SUITE F
    WASILLA, AK
    ZIP 99654
  • Facility Phone: 907 373-5940
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LOETTA M. HORSWILL-WOODS
  • NPI Number: 1578110011
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 02D0993341
LAB Type Physician Office
Facility Name WASILLA INTERNAL MEDICINE LLC
Street 3719 MERIDIAN LOOP SUITE F
City WASILLA
State AK
ZIP 99654
Phone 907 373-5940
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 Physician Office
Lab Director LOETTA M. HORSWILL-WOODS

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