02D1064495 CLIA NUMBER - AURORA KIDNEY LLC

Laboratory Demographics

CLIA Number: 02D1064495

Facility Name: AURORA KIDNEY LLC

Facility Address:
3260 PROVIDENCE DRIVE SUITE 528
ANCHORAGE, AK
ZIP 99508
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Facility Phone Number: 907 865-6965

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1659417137

Taxonomy: 207RN0300X - Internal Medicine
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

CLIA Record

Field Name	Field Value
CLIA Number	02D1064495
LAB Type	Physician Office
Facility Name	AURORA KIDNEY LLC
Street	3260 PROVIDENCE DRIVE SUITE 528
City	ANCHORAGE
State	AK
ZIP	99508
Phone	907 865-6965
CertificateType	3
CertificateEffectiveDate	10/1/2023
CertificateExpirationDate	9/30/2025
FacilityType	PPMP

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