02D1102577 CLIA NUMBER - MAT-SU COMMUNITY BASED OUTPATIENT CLINIC

Laboratory Demographics

  • CLIA Code: 02D1102577
  • Facility Name: MAT-SU COMMUNITY BASED OUTPATIENT CLINIC
  • Facility Address: 865 N SEWARD MERIDIAN PARKWAY
    WASILLA, AK
    ZIP 99654
  • Facility Phone: 907 631-3100
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: NENA WENDZEL
  • NPI Number: 1184725210
  • Taxonomy: 261QM0801X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 02D1102577
LAB Type Community Clinic
Facility Name MAT-SU COMMUNITY BASED OUTPATIENT CLINIC
Street 865 N SEWARD MERIDIAN PARKWAY
City WASILLA
State AK
ZIP 99654
Phone 907 631-3100
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 7/22/2009
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director NENA WENDZEL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025