02D2173299 CLIA NUMBER - RIVER HEALTH & WELLNESS, LLC

Laboratory Demographics

CLIA Number: 02D2173299

Facility Name: RIVER HEALTH & WELLNESS, LLC

Facility Address:
35671 KENAI SPUR HWY, STE 103A
SOLDOTNA, AK
ZIP 99669
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Facility Phone Number: 907 308-4800

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1083264022

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	02D2173299
LAB Type	Practitioner Other
Facility Name	RIVER HEALTH & WELLNESS, LLC
Street	35671 KENAI SPUR HWY, STE 103A
City	SOLDOTNA
State	AK
ZIP	99669
Phone	907 308-4800
CertificateType	4
CertificateEffectiveDate	10/9/2023
CertificateExpirationDate	10/8/2025
FacilityType	Waiver

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