02D2232591 CLIA NUMBER - TRANQUILITY BEH TELEHEALTH

Laboratory Demographics

  • CLIA Code: 02D2232591
  • Facility Name: TRANQUILITY BEH TELEHEALTH
  • Facility Address: 17051 MERCY DR, STE 204
    EAGLE RIVER, AK
    ZIP 99577
  • Facility Phone: 844 995-0577
  • Facility Type: Other - NURSE PRACTITIONER
  • Facility Type: Waiver
  • Lab Director: SHANNON R. DAVIS
  • NPI Number: 1306488572
  • Taxonomy: 363LP0808X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 02D2232591
LAB Type Other - NURSE PRACTITIONER
Facility Name TRANQUILITY BEH TELEHEALTH
Street 17051 MERCY DR, STE 204
City EAGLE RIVER
State AK
ZIP 99577
Phone 844 995-0577
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2025
Certificate Expiration Date 8/15/2027
Facility Type Other - NURSE PRACTITIONER
Lab Director SHANNON R. DAVIS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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