02D1050441 CLIA NUMBER - TRUE NORTH MEDICINE LLC

Laboratory Demographics

CLIA Number: 02D1050441

Facility Name: TRUE NORTH MEDICINE LLC

Facility Address:
12641 OLD GLENN HIGHWAY, SUITE 102
EAGLE RIVER, AK
ZIP 99577
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Facility Phone Number: 907 696-8783

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1588702096

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	02D1050441
LAB Type	Physician Office
Facility Name	TRUE NORTH MEDICINE LLC
Street	12641 OLD GLENN HIGHWAY, SUITE 102
City	EAGLE RIVER
State	AK
ZIP	99577
Phone	907 696-8783
CertificateType	4
CertificateEffectiveDate	2/3/2024
CertificateExpirationDate	2/2/2026
FacilityType	Waiver

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