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

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Laboratory Demographics

CLIA Number: 02D2041524

Facility Name: ALASKA CHILDREN'S HEART CENTER, LLC

Facility Address:
3260 PROVIDENCE DRIVE SUITE 532
ANCHORAGE, AK
ZIP 99508
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Facility Phone Number: 907 565-2242

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1184751075

Taxonomy: 2080P0202X - Pediatrics
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.

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
CertificateType	4
CertificateEffectiveDate	5/23/2022
CertificateExpirationDate	5/22/2024
FacilityType	Waiver

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