02D2271966 CLIA NUMBER - ALPINE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 02D2271966
  • Facility Name: ALPINE MEDICAL GROUP
  • Facility Address: 605 CHIEF THOMAS DRIVE
    FAIRBANKS, AK
    ZIP 99709
  • Facility Phone: 907 455-4555
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HALEY EVENS
  • NPI Number: 1114681608
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 02D2271966
LAB Type Physician Office
Facility Name ALPINE MEDICAL GROUP
Street 605 CHIEF THOMAS DRIVE
City FAIRBANKS
State AK
ZIP 99709
Phone 907 455-4555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/11/2024
Certificate Expiration Date 11/10/2026
Facility Type Physician Office
Lab Director HALEY EVENS

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