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02D1009028 CLIA NUMBER - MOUNTAIN WEST DERM BLACKHART PLLC ALASKA CENTER FOR DERMATOLOGY

Laboratory Demographics

CLIA Number: 02D1009028

Facility Name: MOUNTAIN WEST DERM BLACKHART PLLC ALASKA CENTER FOR DERMATOLOGY

Facility Address:
3841 PIPER STREET SUITE T4-020
ANCHORAGE, AK
ZIP 99508
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Facility Phone Number: 907 646-8505

Facility Type: Physician Office

Certificate Type: Certificate of Compliance
NPI Number: 1124670088

Taxonomy: 207N00000X - Dermatology
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

CLIA Record

Field Name Field Value
CLIA Number 02D1009028
LAB Type Physician Office
Facility Name MOUNTAIN WEST DERM BLACKHART PLLC ALASKA CENTER FOR DERMATOLOGY
Street 3841 PIPER STREET SUITE T4-020
City ANCHORAGE
State AK
ZIP 99508
Phone 907 646-8505
CertificateType 2
CertificateEffectiveDate 8/13/2023
CertificateExpirationDate 8/12/2025
FacilityType Compliance

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