02D2242422 CLIA NUMBER - RUSSELL DEGROOTE MD, PC

Laboratory Demographics

  • CLIA Code: 02D2242422
  • Facility Name: RUSSELL DEGROOTE MD, PC
  • Facility Address: 7559 N TONGASS AVE
    KETCHIKAN, AK
    ZIP 99901
  • Facility Phone: 907 247-9999
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RUSSELL A. DEGROOTE
  • NPI Number: 1689684771
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 02D2242422
LAB Type Physician Office
Facility Name RUSSELL DEGROOTE MD, PC
Street 7559 N TONGASS AVE
City KETCHIKAN
State AK
ZIP 99901
Phone 907 247-9999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/8/2023
Certificate Expiration Date 11/7/2025
Facility Type Physician Office
Lab Director DR. RUSSELL A. DEGROOTE

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