02D2214231 CLIA NUMBER - IDENTITY INC DBA IDENTITY HEALTH CLINIC

Laboratory Demographics

CLIA Number: 02D2214231

Facility Name: IDENTITY INC DBA IDENTITY HEALTH CLINIC

Facility Address:
307 E NORTHERN LIGHTS BLVD STE 101
ANCHORAGE, AK
ZIP 99503
Get Directions

Facility Phone Number: 907 865-3247

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1225633449

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	02D2214231
LAB Type	Community Clinic
Facility Name	IDENTITY INC DBA IDENTITY HEALTH CLINIC
Street	307 E NORTHERN LIGHTS BLVD STE 101
City	ANCHORAGE
State	AK
ZIP	99503
Phone	907 865-3247
CertificateType	3
CertificateEffectiveDate	2/20/2023
CertificateExpirationDate	2/19/2025
FacilityType	PPMP

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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