02D2234289 CLIA NUMBER - ALASKA INCIDENT MANAGEMENT TEAM

Laboratory Demographics

CLIA Number: 02D2234289

Facility Name: ALASKA INCIDENT MANAGEMENT TEAM

Facility Address:
550 WEST 7TH AVE AK DIVISION OF FORESTRY, ATWOOD BUILDING
ANCHORAGE, AK
ZIP 99501
Get Directions

Facility Phone Number: 907 351-2206

Facility Type: Other - FIRE CAMP

Certificate Type: Waiver

NPI Number: 1104464460

Taxonomy: 363LP0808X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	02D2234289
LAB Type	Other - FIRE CAMP
Facility Name	ALASKA INCIDENT MANAGEMENT TEAM
Street	550 WEST 7TH AVE AK DIVISION OF FORESTRY, ATWOOD BUILDING
City	ANCHORAGE
State	AK
ZIP	99501
Phone	907 351-2206
CertificateType	4
CertificateEffectiveDate	8/30/2023
CertificateExpirationDate	8/29/2025
FacilityType	Waiver

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