02D2087545 CLIA NUMBER - WILD IRIS FAMILY MEDICINE & MATERNITY CARE

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Laboratory Demographics

CLIA Number: 02D2087545

Facility Name: WILD IRIS FAMILY MEDICINE & MATERNITY CARE

Facility Address:
851 E WESTPOINT DR SUITE 207
WASILLA, AK
ZIP 99654
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Facility Phone Number: 907 373-9453

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1003244211

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	02D2087545
LAB Type	Physician Office
Facility Name	WILD IRIS FAMILY MEDICINE & MATERNITY CARE
Street	851 E WESTPOINT DR SUITE 207
City	WASILLA
State	AK
ZIP	99654
Phone	907 373-9453
CertificateType	4
CertificateEffectiveDate	11/26/2022
CertificateExpirationDate	11/25/2024
FacilityType	Waiver

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