02D2167773 CLIA NUMBER - GOLDSTAR LONGEVITY AND WELLNESS

Laboratory Demographics

  • CLIA Code: 02D2167773
  • Facility Name: GOLDSTAR LONGEVITY AND WELLNESS
  • Facility Address: 751 OLD RICHARDSON HIGHWAY, STE 200
    FAIRBANKS, AK
    ZIP 99701
  • Facility Phone: 907 457-9420
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. RUSSELL S. PIERCE
  • NPI Number: 1427532613
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

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
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/12/2024
Certificate Expiration Date 9/11/2026
Facility Type Physician Office
Lab Director DR. RUSSELL S. PIERCE

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: 9/29/2025