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02D2167773 CLIA NUMBER - GOLDSTAR LONGEVITY AND WELLNESS

Laboratory Demographics

CLIA Number: 02D2167773

Facility Name: GOLDSTAR LONGEVITY AND WELLNESS

Facility Address:
751 OLD RICHARDSON HIGHWAY, STE 200
FAIRBANKS, AK
ZIP 99701
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Facility Phone Number: 907 457-9420

Facility Type: Physician Office

Certificate Type: Microscopy
NPI Number: 1427532613

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 02D2167773
LAB Type Physician Office
Facility Name GOLDSTAR LONGEVITY AND WELLNESS
Street 751 OLD RICHARDSON HIGHWAY, STE 200
City FAIRBANKS
State AK
ZIP 99701
Phone 907 457-9420
CertificateType 3
CertificateEffectiveDate 9/12/2022
CertificateExpirationDate 9/11/2024
FacilityType PPMP

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