02D2130097 CLIA NUMBER - HOLISTIC INTEGRATIVE MEDICINE, LLC

Laboratory Demographics

CLIA Number: 02D2130097

Facility Name: HOLISTIC INTEGRATIVE MEDICINE, LLC

Facility Address:
37060 CONNER ROAD
SOLDOTNA, AK
ZIP 99669
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Facility Phone Number: (855) 436-7723

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1629501408

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	02D2130097
LAB Type	PHYSICIAN OFFICE
Facility Name	HOLISTIC INTEGRATIVE MEDICINE, LLC
Street	37060 CONNER ROAD
City	SOLDOTNA
State	AK
ZIP	99669
Phone	(855) 436-7723

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This page was last updated on: 5/11/2023