02D2155324 CLIA NUMBER - SUSITNA SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 02D2155324
  • Facility Name: SUSITNA SURGERY CENTER, LLC
  • Facility Address: 2490 S WOODWORTH LOOP, SUITE 100
    PALMER, AK
    ZIP 99645
  • Facility Phone: 907 861-6540
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KRISTI EASH
  • NPI Number: 1073009304
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 02D2155324
LAB Type Ambulatory Surgery Center
Facility Name SUSITNA SURGERY CENTER, LLC
Street 2490 S WOODWORTH LOOP, SUITE 100
City PALMER
State AK
ZIP 99645
Phone 907 861-6540
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Ambulatory Surgery Center
Lab Director KRISTI EASH

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