02D1011632 CLIA NUMBER - HEIRLOOM WELLNESS AND BIRTH, LLC

Laboratory Demographics

  • CLIA Code: 02D1011632
  • Facility Name: HEIRLOOM WELLNESS AND BIRTH, LLC
  • Facility Address: 2323 S TRUNK RD
    PALMER, AK
    ZIP 99645
  • Facility Phone: 907 746-6644
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KIRSTEN A. GERRISH
  • NPI Number: 1457659906
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 02D1011632
LAB Type Practitioner Other
Facility Name HEIRLOOM WELLNESS AND BIRTH, LLC
Street 2323 S TRUNK RD
City PALMER
State AK
ZIP 99645
Phone 907 746-6644
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Practitioner Other
Lab Director KIRSTEN A. GERRISH

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