02D0996845 CLIA NUMBER - ALASKA HEART INSTITUTE LLC

Laboratory Demographics

CLIA Number: 02D0996845

Facility Name: ALASKA HEART INSTITUTE LLC

Facility Address:
3125 E MERIDIAN PARK LOOP, STE 200
WASILLA, AK
ZIP 99654
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Facility Phone Number: 907 761-5470

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1306349667

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	02D0996845
LAB Type	Physician Office
Facility Name	ALASKA HEART INSTITUTE LLC
Street	3125 E MERIDIAN PARK LOOP, STE 200
City	WASILLA
State	AK
ZIP	99654
Phone	907 761-5470
CertificateType	4
CertificateEffectiveDate	2/27/2024
CertificateExpirationDate	2/26/2026
FacilityType	Waiver

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