02D1030635 CLIA NUMBER - SOUTHCENTRAL FOUNDATION - AMBULATORY CLINICS

Laboratory Demographics

  • CLIA Code: 02D1030635
  • Facility Name: SOUTHCENTRAL FOUNDATION - AMBULATORY CLINICS
  • Facility Address: 4501 DIPLOMACY DRIVE
    ANCHORAGE, AK
    ZIP 99508
  • Facility Phone: 907 729-1230
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DONNA GALBREATH
  • NPI Number: 1669681755
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 02D1030635
LAB Type Physician Office
Facility Name SOUTHCENTRAL FOUNDATION - AMBULATORY CLINICS
Street 4501 DIPLOMACY DRIVE
City ANCHORAGE
State AK
ZIP 99508
Phone 907 729-1230
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/15/2025
Certificate Expiration Date 4/14/2027
Facility Type Physician Office
Lab Director DONNA GALBREATH

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