02D1087950 CLIA NUMBER - MIDNIGHT SUN ONCOLOGY PARTNERS

Laboratory Demographics

CLIA Number: 02D1087950

Facility Name: MIDNIGHT SUN ONCOLOGY PARTNERS

Facility Address:
2490 SOUTH WOODWORTH LP, SUITE 499
PALMER, AK
ZIP 99645
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Facility Phone Number: 907 746-7771

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1770967598

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	02D1087950
LAB Type	Physician Office
Facility Name	MIDNIGHT SUN ONCOLOGY PARTNERS
Street	2490 SOUTH WOODWORTH LP, SUITE 499
City	PALMER
State	AK
ZIP	99645
Phone	907 746-7771
CertificateType	2
CertificateEffectiveDate	3/31/2023
CertificateExpirationDate	3/30/2025
FacilityType	Compliance

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