02D1095759 CLIA NUMBER - ALASKA CENTER FOR EAR NOSE AND THROAT, LLC DRS ELLERBE & KALLMAN, INC

Laboratory Demographics

CLIA Number: 02D1095759

Facility Name: ALASKA CENTER FOR EAR NOSE AND THROAT, LLC DRS ELLERBE & KALLMAN, INC

Facility Address:
3841 PIPER STREE, SUITE 230
ANCHORAGE, AK
ZIP 99508
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Facility Phone Number: 907 279-8800

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1821046152

Taxonomy: 207YS0123X - Otolaryngology
An otolaryngologist who specializes in facial plastic surgery.

CLIA Record

Field Name	Field Value
CLIA Number	02D1095759
LAB Type	Physician Office
Facility Name	ALASKA CENTER FOR EAR NOSE AND THROAT, LLC DRS ELLERBE & KALLMAN, INC
Street	3841 PIPER STREE, SUITE 230
City	ANCHORAGE
State	AK
ZIP	99508
Phone	907 279-8800
CertificateType	4
CertificateEffectiveDate	2/17/2023
CertificateExpirationDate	2/16/2025
FacilityType	Waiver

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