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

Laboratory Demographics

  • CLIA Code: 02D2087545
  • Facility Name: WILD IRIS FAMILY MEDICINE & MATERNITY CARE
  • Facility Address: 851 E WESTPOINT DR SUITE 207
    WASILLA, AK
    ZIP 99654
  • Facility Phone: 907 373-9453
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TARA QUINTON
  • NPI Number: 1003244211
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/26/2024
Certificate Expiration Date 11/25/2026
Facility Type Physician Office
Lab Director TARA QUINTON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025