02D2259552 CLIA NUMBER - PIVOTAL CARE PARTNERSHIP

Laboratory Demographics

  • CLIA Code: 02D2259552
  • Facility Name: PIVOTAL CARE PARTNERSHIP
  • Facility Address: 1200 AIRPORT HEIGHTS DR, STE 240
    ANCHORAGE, AK
    ZIP 99508
  • Facility Phone: 907 375-2025
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JE DETTE A. GREEN
  • NPI Number: 1811596026
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 02D2259552
LAB Type Physician Office
Facility Name PIVOTAL CARE PARTNERSHIP
Street 1200 AIRPORT HEIGHTS DR, STE 240
City ANCHORAGE
State AK
ZIP 99508
Phone 907 375-2025
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2024
Certificate Expiration Date 5/6/2026
Facility Type Physician Office
Lab Director JE DETTE A. GREEN

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