02D1022168 CLIA NUMBER - REIFENSTEIN DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 02D1022168

Facility Name: REIFENSTEIN DIALYSIS CENTER

Facility Address:
9109 MENDENHALL MALL SUITE 6
JUNEAU, AK
ZIP 99801
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Facility Phone Number: 907 790-3002

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1215049010

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	02D1022168
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	REIFENSTEIN DIALYSIS CENTER
Street	9109 MENDENHALL MALL SUITE 6
City	JUNEAU
State	AK
ZIP	99801
Phone	907 790-3002
CertificateType	4
CertificateEffectiveDate	2/9/2024
CertificateExpirationDate	2/8/2026
FacilityType	Waiver

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