02D2185030 CLIA NUMBER - KARIS INTEGRATIVE MEDICINE

Laboratory Demographics

CLIA Number: 02D2185030

Facility Name: KARIS INTEGRATIVE MEDICINE

Facility Address:
851 E WESTPOINT DR STE 301
WASILLA, AK
ZIP 99654
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Facility Phone Number: 907 982-7821

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1174151708

Taxonomy: 363LW0102X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	02D2185030
LAB Type	Practitioner Other
Facility Name	KARIS INTEGRATIVE MEDICINE
Street	851 E WESTPOINT DR STE 301
City	WASILLA
State	AK
ZIP	99654
Phone	907 982-7821
CertificateType	4
CertificateEffectiveDate	5/28/2022
CertificateExpirationDate	5/27/2024
FacilityType	Waiver

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