02D2013743 CLIA NUMBER - CENTRAL PENINSULA FAMILY PRACTICE-SOLDOTNA

Laboratory Demographics

  • CLIA Code: 02D2013743
  • Facility Name: CENTRAL PENINSULA FAMILY PRACTICE-SOLDOTNA
  • Facility Address: 245 BINKLEY ST SUITE 101
    SOLDOTNA, AK
    ZIP 99669
  • Facility Phone: 907 714-4111
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STACY NEWBERN
  • NPI Number: 1831404805
  • Taxonomy: 282NR1301X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 02D2013743
LAB Type Physician Office
Facility Name CENTRAL PENINSULA FAMILY PRACTICE-SOLDOTNA
Street 245 BINKLEY ST SUITE 101
City SOLDOTNA
State AK
ZIP 99669
Phone 907 714-4111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2024
Certificate Expiration Date 9/22/2026
Facility Type Physician Office
Lab Director STACY NEWBERN

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