02D2041524 CLIA NUMBER - ALASKA CHILDREN'S HEART CENTER, LLC

Laboratory Demographics

  • CLIA Code: 02D2041524
  • Facility Name: ALASKA CHILDREN'S HEART CENTER, LLC
  • Facility Address: 3260 PROVIDENCE DRIVE SUITE 532
    ANCHORAGE, AK
    ZIP 99508
  • Facility Phone: 907 565-2242
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SCOTT A. WELLMANN
  • NPI Number: 1184751075
  • Taxonomy: 2080P0202X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 02D2041524
LAB Type Physician Office
Facility Name ALASKA CHILDREN'S HEART CENTER, LLC
Street 3260 PROVIDENCE DRIVE SUITE 532
City ANCHORAGE
State AK
ZIP 99508
Phone 907 565-2242
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2024
Certificate Expiration Date 5/22/2026
Facility Type Physician Office
Lab Director SCOTT A. WELLMANN

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