02D1052327 CLIA NUMBER - INSIDE PASSAGE MIDWIFERY & NATURAL MED LLC

Laboratory Demographics

CLIA Number: 02D1052327

Facility Name: INSIDE PASSAGE MIDWIFERY & NATURAL MED LLC

Facility Address:
853 BASIN ROAD
JUNEAU, AK
ZIP 99801
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Facility Phone Number: 907 463-2600

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1083907711

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	02D1052327
LAB Type	Practitioner Other
Facility Name	INSIDE PASSAGE MIDWIFERY & NATURAL MED LLC
Street	853 BASIN ROAD
City	JUNEAU
State	AK
ZIP	99801
Phone	907 463-2600
CertificateType	4
CertificateEffectiveDate	3/22/2024
CertificateExpirationDate	3/21/2026
FacilityType	Waiver

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