02D2247724 CLIA NUMBER - SOUTHCENTRAL FOUNDATION DETOX PROGRAM

Laboratory Demographics

  • CLIA Code: 02D2247724
  • Facility Name: SOUTHCENTRAL FOUNDATION DETOX PROGRAM
  • Facility Address: 4330 ELMORE ROAD
    ANCHORAGE, AK
    ZIP 99508
  • Facility Phone: 907 729-1230
  • Facility Type: Other - TRIBAL FACILITY
  • Facility Type: Microscopy
  • Lab Director: JENNIFER SASS
  • NPI Number: 1174734503
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 02D2247724
LAB Type Other - TRIBAL FACILITY
Facility Name SOUTHCENTRAL FOUNDATION DETOX PROGRAM
Street 4330 ELMORE ROAD
City ANCHORAGE
State AK
ZIP 99508
Phone 907 729-1230
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/8/2024
Certificate Expiration Date 1/7/2026
Facility Type Other - TRIBAL FACILITY
Lab Director JENNIFER SASS

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