02D2121048 CLIA NUMBER - ANCHORAGE GOSPEL RESCUE MISSION

Laboratory Demographics

  • CLIA Code: 02D2121048
  • Facility Name: ANCHORAGE GOSPEL RESCUE MISSION
  • Facility Address: 2823 E TUDOR ROAD
    ANCHORAGE, AK
    ZIP 99507
  • Facility Phone: 907 563-5603
  • Facility Type: Other - LIFE SKILLS
  • Facility Type: Waiver
  • Lab Director: MR. JOHN LAMANTIA
  • NPI Number: 1659777639
  • Taxonomy: 235Z00000X - Speech-Language Pathologist

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CLIA Record

Field Name Field Value
CLIA Number 02D2121048
LAB Type Other - LIFE SKILLS
Facility Name ANCHORAGE GOSPEL RESCUE MISSION
Street 2823 E TUDOR ROAD
City ANCHORAGE
State AK
ZIP 99507
Phone 907 563-5603
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Other - LIFE SKILLS
Lab Director MR. JOHN LAMANTIA

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