02D2177251 CLIA NUMBER - ALASKA TREATMENT CENTER

Laboratory Demographics

  • CLIA Code: 02D2177251
  • Facility Name: ALASKA TREATMENT CENTER
  • Facility Address: 1577 C STREET, STE 204
    ANCHORAGE, AK
    ZIP 99501
  • Facility Phone: 907 538-9958
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DAVID N. AMPONG
  • NPI Number: 1104464460
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 02D2177251
LAB Type Practitioner Other
Facility Name ALASKA TREATMENT CENTER
Street 1577 C STREET, STE 204
City ANCHORAGE
State AK
ZIP 99501
Phone 907 538-9958
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2024
Certificate Expiration Date 1/6/2026
Facility Type Practitioner Other
Lab Director DAVID N. AMPONG

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