02D2181606 CLIA NUMBER - SWIFTWATER DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 02D2181606
  • Facility Name: SWIFTWATER DERMATOLOGY
  • Facility Address: 130 EAST REDOUBT AVENUE
    SOLDOTNA, AK
    ZIP 99669
  • Facility Phone: 907 398-3376
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. KRISTIN L. EASTMAN
  • NPI Number: 1760034045
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 02D2181606
LAB Type Physician Office
Facility Name SWIFTWATER DERMATOLOGY
Street 130 EAST REDOUBT AVENUE
City SOLDOTNA
State AK
ZIP 99669
Phone 907 398-3376
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 4/7/2024
Certificate Expiration Date 4/6/2026
Facility Type Physician Office
Lab Director DR. KRISTIN L. EASTMAN

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