02D2276977 CLIA NUMBER - BANYAN ALASKA LLC

Laboratory Demographics

  • CLIA Code: 02D2276977
  • Facility Name: BANYAN ALASKA LLC
  • Facility Address: 4750 E BEGICH CIRCLE
    WASILLA, AK
    ZIP 99654
  • Facility Phone: 954 533-7705
  • Facility Type: Other - SUBSTANCE ABUSE TREATMENT
  • Facility Type: Waiver
  • Lab Director: SHERILYN TORO
  • NPI Number: 1902518848
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 02D2276977
LAB Type Other - SUBSTANCE ABUSE TREATMENT
Facility Name BANYAN ALASKA LLC
Street 4750 E BEGICH CIRCLE
City WASILLA
State AK
ZIP 99654
Phone 954 533-7705
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type Other - SUBSTANCE ABUSE TREATMENT
Lab Director SHERILYN TORO

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