02D2180854 CLIA NUMBER - REDOUBT MEDICAL GROUP, LLC

Laboratory Demographics

  • CLIA Code: 02D2180854
  • Facility Name: REDOUBT MEDICAL GROUP, LLC
  • Facility Address: 130 S WILLOW ST, STE 1
    KENAI, AK
    ZIP 99611
  • Facility Phone: 907 283-6030
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JOAN MERRICK
  • NPI Number: 1609944271
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 02D2180854
LAB Type Physician Office
Facility Name REDOUBT MEDICAL GROUP, LLC
Street 130 S WILLOW ST, STE 1
City KENAI
State AK
ZIP 99611
Phone 907 283-6030
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 3/21/2024
Certificate Expiration Date 3/20/2026
Facility Type Physician Office
Lab Director JOAN MERRICK

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