02D2203499 CLIA NUMBER - FIREWEED PEDIATRICS

Laboratory Demographics

  • CLIA Code: 02D2203499
  • Facility Name: FIREWEED PEDIATRICS
  • Facility Address: 1875 UNIVERSITY AVE S UNIT 1
    FAIRBANKS, AK
    ZIP 99709
  • Facility Phone: 907 328-0875
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. LETHA C. ARCHER
  • NPI Number: 1386322444
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 02D2203499
LAB Type Physician Office
Facility Name FIREWEED PEDIATRICS
Street 1875 UNIVERSITY AVE S UNIT 1
City FAIRBANKS
State AK
ZIP 99709
Phone 907 328-0875
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/3/2024
Certificate Expiration Date 12/2/2026
Facility Type Physician Office
Lab Director DR. LETHA C. ARCHER

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