02D1016000 CLIA NUMBER - LATOUCHE PEDIATRICS LLC

Laboratory Demographics

CLIA Number: 02D1016000

Facility Name: LATOUCHE PEDIATRICS LLC

Facility Address:
1301 EAST HUFFMAN SUITE 110
ANCHORAGE, AK
ZIP 99515
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Facility Phone Number: 907 562-2120

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1780221127

Taxonomy: 261QM0855X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

CLIA Record

Field Name	Field Value
CLIA Number	02D1016000
LAB Type	Physician Office
Facility Name	LATOUCHE PEDIATRICS LLC
Street	1301 EAST HUFFMAN SUITE 110
City	ANCHORAGE
State	AK
ZIP	99515
Phone	907 562-2120
CertificateType	4
CertificateEffectiveDate	8/18/2023
CertificateExpirationDate	8/17/2025
FacilityType	Waiver

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