02D2081322 CLIA NUMBER - EAGLE RIVER VISION CLINIC INC

Laboratory Demographics

  • CLIA Code: 02D2081322
  • Facility Name: EAGLE RIVER VISION CLINIC INC
  • Facility Address: 16331 HERITAGE PLACE SUITE 104
    EAGLE RIVER, AK
    ZIP 99577
  • Facility Phone: 907 694-2511
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT J. FLECKENSTEIN
  • NPI Number: 1558301945
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 02D2081322
LAB Type Physician Office
Facility Name EAGLE RIVER VISION CLINIC INC
Street 16331 HERITAGE PLACE SUITE 104
City EAGLE RIVER
State AK
ZIP 99577
Phone 907 694-2511
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Physician Office
Lab Director ROBERT J. FLECKENSTEIN

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