02D2180853 CLIA NUMBER - DENALI BIOMEDICAL, LLC

Laboratory Demographics

CLIA Number: 02D2180853

Facility Name: DENALI BIOMEDICAL, LLC

Facility Address:
607 OLD STEESEE HIGHWAY, B306
FAIRBANKS, AK
ZIP 99709
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Facility Phone Number: 907 328-0989

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1205424165

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	02D2180853
LAB Type	Ambulatory Surgery Center
Facility Name	DENALI BIOMEDICAL, LLC
Street	607 OLD STEESEE HIGHWAY, B306
City	FAIRBANKS
State	AK
ZIP	99709
Phone	907 328-0989
CertificateType	4
CertificateEffectiveDate	3/21/2024
CertificateExpirationDate	3/20/2026
FacilityType	Waiver

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